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CONTENTS

Schizophrenia and Delusions ...... 6

Heresy, Lunacy and Rumours of Madness ...... 9

Disease Creation ...... 11 eugenics and psychiatry in Australia ...... 29

Schizophrenia and Dopamine Blockers ...... 40

A Psychoanalysis of Psychiatry ...... 54

Private Hospitals and Military Connections ...... 67

Behaviour Control and Social Control ...... 84

Legacies of a Prison Colony ...... 123

British Prejudices in its Colonies ...... 140

Mental Patient Rights in Australia...... 154

Eugenics and ‘Mental Hygeine’ ...... 157

Organised Selling of Madness ...... 175

Reasons for Diagnosis of Schizophrenia ...... 190

Social Control and Delusions of Control ...... 212

Self-Fulfilling Prophesies ...... 218

Persecution in the Guise of Psychiatry: soviet and NAZI Examples ...... 235 3

Research on Dead Mental Patients in Australia ...... 244

Telepathy and Diagnosis of Schizophrenia ...... 252

Nasty Labels ...... 264

Religious Wars for converts and madness ...... 271

A Cure for Schizophrenia! ...... 344

The Amine Hypothesis in a New Light ...... 381

Looking for Love and Emotional Health ...... 405

Freedom of Movement and Chemical Restraints ...... 419

Mind Over Matter or Matter Over Mind? ...... 434

Disease Creation by Psychiatry – some diagrams ...... 452

REFERENCES:...... 457

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Introduction Schizophrenia is a term that was coined in 1908 by the Swiss psychiatrist Eugen Bleuler. Since then, the criteria used to diagnose schizophrenia have changed considerably. This book presents evidence that the term has little scientific justification, and should be abandoned.

Though I believe that the term ‘schizophrenia’ is a label that does more harm than good, I don’t believe that “mental illness doesn’t exist”. On the contrary, I believe that some degree of mental illhealth is close to ubiquitous. Delusions are widespread and affect most people to some degree – delusions are actively propagated by the mass-media, by political and religious organizations and, for that matter, the holy books of different religions. Delusions are inflicted on children by their parents and teachers; though some of what is taught is true and correct, some is not – such incorrect information, however widely held, remains delusional.

The treatment of delusions by the psychiatry profession is centred on drugs rather than counseling. It is difficult for a profession that is profoundly deluded itself to remedy delusions though talk therapies. In reality, the psychiatry profession focuses on convincing patients that they suffer from incurable mental illnesses – by this token, accepting that one has schizophrenia is regarded as “gaining insight”. It is a widely held doctrine in psychiatry that people with ‘schizophrenia’ and ‘mania’ are notorious for “lack of insight” – in other words they do not regard themselves as mentally ill until they are convinced that they are by the psychiatry profession and its agents. The coercive nature of psychiatry results in people being punished by incarceration and injections until and unless they accept that they have such incurable mental illness (and agree to take drugs ‘volunatrily’).

There is no greater insult than to be told that one has a sick mind. The colloquialism of a ‘sick mind’ is synonymous with evil. It also supposes that the mainstream of thinking is 5

‘healthy’, while those who hold contrary beliefs are deluded. Yet the mainstream remains deluded about many things. Only a fool believes everything on television. One needs to be naïve in the extreme to think that there are no vested interests involved in what is televised and promoted as true by the ‘mainstream’.

Delusional thinking is but one of several characteristics of ‘schizophrenia’. The other important criterion for the diagnosis of schizophrenia is hallucinations, especially auditory hallucinations. Bleuler’s initial formulation for the label included auditory hallucinations, and this was stressed in the 1959 re-formulation of schizophrenia by the German psychiatrist Kurt Schneider in his list “first rank symptoms”.

Though antipsychotic drugs (and SSRI antidepressants) can sometimes cause hallucinations, it seems likely that low doses of antipsychotic drugs can reduce auditory hallucinations, and have a place in their treatment. It is also important, though, to address the various environmental causes of hallucinations, rather than relying on such drugs in the long term. The fact that people do experience hallucinations at times does not justify the label of schizophrenia. Instead, certain people may be said to have a tendency to auditory hallucinations – this avoids the stigma of the terms “schizophrenia” and “mental illness”.

The other term that is often used in reference to schizophrenia is that of “psychosis”. Though this is a pathologisation of the Greek for “process” (-osis), which in this case is taken to mean “disease process”, the word psychosis is usually interpreted as being “out of touch with reality”. But who is to be the judge of reality? And can we be sure that the psychiatry profession and medical profession (more broadly) are “in touch with reality”?

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SCHIZOPHRENIA AND DELUSIONS

Delusions are regarded as typical symptoms of the supposedly incurable mental illness termed “schizophrenia”. This is claimed, in psychiatric texts, to be a serious brain disease that affects about one percent of the world’s population: about 60 million people. Of these, 5 to 15 percent (3 to 9 million people, mostly under the age of 40) are predicted to commit suicide. This usually is said to be an unavoidable consequence of the illness, and not a consequence of diagnosis and treatment.

Like other medical and scientific assumptions, such claims by the psychiatry profession must be critically examined and rejected if logically unsound. Given that iatrogenic (treatment-induced) illness exists, and the mechanisms by which medical diagnosis and treatment can cause illness and death are well established, it is surely necessary that we look carefully at all areas of contemporary psychiatric practice for flaws, and correct any situations in which illness is being created rather than cured.

This is especially important because mental illness has been predicted, by the influential World Health Organization, to increase in the years to come. Because of well-documented psychiatric abuses in the past related to the history of psychiatry as an agent of political and social control, it is crucial that this branch of medicine be examined closely, looking at its possible role in increasing suicide rates, creating drug addiction, promoting depression and other mental illnesses, and labeling normal and abnormal in order to generate bigger profits from their patients.

The relationship between the psychiatric profession and the pharmaceutical industry will be closely examined in this book, in which in which I will illustrate the blurred line between various ‘mental health promotion’ strategies and ‘drug marketing’ strategies. In reality, far from lurking on street 7

corners, the biggest drug pushers in Australia (and elsewhere) are sitting in comfortable chairs in men’s clubs and lodges, playing golf with political leaders and receiving both private and public money in the form of government grants, and even cash, collectables, antiques, real estate and other treasures left to them in the wills of people who have been slowly killed by the psychiatry treatments.

The potential for pessimistic prognoses to create disease is obvious, and psychiatry is a particularly pessimistic area of medicine. Hundreds of “disorders” have been named, all incurable, but all ‘treatable’ with drugs. In the case of ‘schizophrenia’ these drugs are notorious for causing ‘side-effects’ and long term brain damage. They cause chronic illness, in other words. While this is undisputed, it is argued that the “untreated condition” is worse than the treatment or the state of chronic debility that is produced by long term ingestion (or injection) of dopamine-blocking drugs, and more recently drugs that block serotonin receptors.

Justification for the use of such drugs, and the continued use of what many regard as cruel, stigmatizing labels by the medical and mental health professions will be challenged in the following pages, in which the hypothesis will be presented that what is described in medical texts as ‘schizophrenia’ is primarily an iatrogenic (treatment induced) illness.

I also am not opposed to the use of pharmaceutical medicines in a sensible, ethical and scientifically valid way. I believe that there are many valuable drugs and have prescribed them regularly, over the years, in my work as a family physician. The phenomenon I abhor is that of marketing drugs and other treatments with the sole objective of financial gain, and with no regard for the health and rights of the people that are experimented on or treated with excessive doses of drugs or for excessive periods of time, simply because the drug company or treating doctors will make more money that way.

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This involves relatively few of my profession, however these unscrupulous doctors and professors are responsible for a great betrayal of the trusting public. Our political leaders and media accord these crooked dons much respect, and may be disturbed by my findings or my criticism of these (mainly) men, some of whom have become icons in our society. I have also reason to be critical of religious institutions in general, and the Christian Churches in particular, because of their involvement in centuries of cruel treatment of those deemed to be mentally ill.

Many the conclusions I have drawn from my research over the past four years are damning on the medical profession and psychiatry profession in particular. I also have reason to believe that the pharmaceutical industry and related industries have been responsible for some of the greatest crimes of history, profiteering from the misery and illness of millions, by the promotion of drugs combined with promotion (and deliberate creation) of diseases that justify the use of these drugs.

I do not, however, believe that many of the people involved in the creation of disease are motivated by wicked intentions. Many believe that their actions are necessary for the greater good, or necessary for the treatment of incurably sick people. Others would prefer not to look at the ethics of what they do at all, reassuring themselves that “everybody else does it too”. Yet others are confused by moral issues, or fear to speak out because of possible repercussions such as losing their job, their reputation or their funding. Some fear even harsher punishment, including being called mad and being punitively treated for it.

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HERESY, LUNACY AND RUMOURS OF MADNESS

People have been, and still are judged as mad, or insane, mainly, or entirely, because of opposition to, or defiance of, the laws, doctrines and authority of dominant religions. Heresies, in other words. In Australia, the dominant religion, since colonisation by the British, has been ‘Christianity’. The Christian Church is not, of course, a single entity, but rather a number of hierarchical institutions sometimes cooperating, but also at war with each other – in the age-old battle for ‘converts’.

Religious institutions, including Christian churches, have also tacitly supported open warfare between different countries (for example, during the first and second world wars). Since the Crusades, many wars have been fought with claims that God was on the side of the aggressors, with little evidence of the Roman Church and its subsequent Protestant rivals ‘turning the other cheek’.

Various Christian churches have been responsible for, or complicit in terrible atrocities against Indigenous people in Australia and around the world. These have been subject to, at best, ignorant efforts to ‘civilize’ them, and at worst, cruel and degrading treatments and punishments of unimaginable cruelty. These include misguided efforts to ‘protect’ children from their biological parents to bring them up in “good, white, Christian families” and “missions”, or even punitive Government institutions where they had prematurely short and horribly miserable lives in captivity, physically and psychologically.

In the missions, still within living memory of many Aboriginal Australians, children were punished for speaking their many languages and forced to speak English, as taught by various Christian missionaries. This meant learning Bible stories and singing English hymns, believing in the Christian 10

miracles, praying to a White God and believing in creation as spelt out in Genesis, the first chapter of the Christian Bible, rather than as taught by their parents and grandparents as ‘dreamtime’ fables and legends that had been transmitted orally for millennia.

Long before the colonisation of Australia the grotesque Inquisition, first instituted by the Roman Church, was characterised by systematic terrorisation, torture and mass-murder of men, women and even children accused of heresy. Proscribed beliefs and behaviour, seen as evidence of ‘possession’, included talking to birds and animals, dancing spontaneously, singing songs that were not acceptable to the Church, and scientific beliefs contrary to the doctrines enshrined in the Bible. Other practices, many of which have seen resurgence in modern times in various New Age religions, were denounced as ‘witchcraft’, ranging from belief in communication with the dead and reincarnation to medicinal use of herbs. Thousands of women were tortured in the cruellest ways imaginable, imprisoned for years, or ‘relaxed’, as the Inquisitors termed the hideous practice of burning people alive.

If one examines the criteria used today for the diagnosis of schizophrenia and mania (and the broader term ‘psychosis’) it is evident that many of the beliefs and behaviours that were condemned as “witchcraft” by the Christian inquisitors are now seen as evidence of serious mental illness, warranting forced incarceration and drugging. It is declared by the strident “biological psychiatrists” (as they call themselves) that this behavior is caused by a “chemical imbalance in their brains”. This is despite the fact that these beliefs and behaviours are promoted by a plethora of New Age books that exort the young (and older) public to believe in telepathy, spells, magic, tarot cards, clairvoyance, reincarnation, channeling, astral travel, crystal healing and a range of things that have been proscribed by both the church (of all denominations) and the state (via the public hospital and university-based psychiatry establishment).

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DISEASE CREATION

This book explores in detail the politics, economics and science of disease creation by the psychiatry profession, especially as it relates to labels of ‘schizophrenia’ and ‘psychosis’. The motives for disease creation are many, as will be seen, including profits for drug companies and those providing ‘treatment services’ together with profits for those providing pathology, radiology and other ‘medical investigations’, and the acquisition of funds for ‘medical’ and ‘mental health’ research. These, and other, motives provide a powerful disincentive for cures versus ‘long term treatment’. The medical profession has been slowly transformed from a ‘healing profession’ to a referral machine prescribing endless drugs for maladies that can be successfully managed without pharmaceutical treatments.

In this book you will find evidence of what the American psychologist Seth Farber has called an “Orwellian Therapeutic State” assuming a position of dominance in the modern world, and details of what the courageous Australian reporter Ray Moynihan called ‘disease-mongering’ in his 1997 book Too Much Medicine.

In this analysis, some of the reasons why schizophrenia is diagnosed today will be looked at critically, together with common medical and community assumptions about “mental disorders” including schizophrenia. The influence of religion and politics on the development of concepts regarding madness and the application of psychiatric labels will also be explored, and a model for developing strategies to create healing psychotherapy based on talk therapies for psychosis and delusions will be presented. By doing so it is hoped that the threat of millions dying by their own hand because of belief they have schizophrenia, or slowly killed by over-prescription of drugs with crippling side-effects can be averted.

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While not questioning the validity of their pessimistic fears, the Oxford Textbook of Medicine (1998) reports that:

“About 10 per cent of schizophrenics die by suicide; the risk is particularly great in younger patients with sufficient insight to appreciate the likely effects of the illness of their hopes and plans.” (p.4222)

The World Health Organization publication The Management of Mental Disorders, Vol 2: Handbook for the Schizophrenic Disorders (1995) claims:

“Overall, the rate of suicide among individuals with schizophrenia is approximately 10% in the first five years following diagnosis. Suicide is often related to depression but may also occur in the absence of depression, sometimes in response to delusional beliefs. Other factors associated with depression and suicide include: a sense of personal loss; loss of future hope; low self- esteem through being labelled and stigmatised; a feeling of not being in control of things; unpleasant symptoms; overmedication; or traumatic experiences while in hospital.” (p.73)

Here we have a rare admission from the medical profession that the treatment given to people diagnosed with schizophrenia, and the diagnosis itself, might contribute to their high rate of suicide, together with their fears about the future consequent on diagnosis. The following diagram explores the ways in which belief that one has a sick mind contributes to suicide and a sense of hopelessness.

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Obviously, how young people envisage the effects of schizophrenia depends on what they believe about ‘schizophrenia’. This, in turn, depends on what they are told and what they read about it, what they see on television and what they gather by talking to “other schizophrenics”.

If a young person attempts suicide or commits suicide because he or she despairs of the future on account of a diagnosis of schizophrenia, the reasons for such hopelessness are clearly evident in psychiatry and psychology textbooks, popular psychiatry books and “public educational literature” together with media portrayals of “paranoid schizophrenics”. The American textbook Psychology (1995) by David Myers, from which university students can add to their misconceptions, describes schizophrenia thus:

“If depression is the common cold of psychological disorders, chronic schizophrenia is the cancer. About 1 in 100 people will develop schizophrenia, joining millions who have suffered one of humanity’s most dreaded disorders.” (p.523)

“Schizophrenia”, more than any other psychiatric diagnosis is associated with stereotypical ideas of madness: it brings to the mind of the uninformed frightening images of deranged, deluded, dangerous people who ‘hear imaginary voices’ and behave in bizarre, unpredictable, frightening ways. How people imagine and judge “complete insanity”, “stark, raving madness”, “total lunacy” and other synonyms for serious madness are as varied as the individual experiences of members of the human race. Most people have made, at some stage, judgments of others, at least in the privacy of their own minds, regarding madness. They may have thought someone to be “disturbed”, “deranged”, “crazy, “a nut”, a “fruit-loop”, a “weirdo”, a “lunatic”, a “psycho”, a “madman” or some other similar derogatory term.

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Is ‘schizophrenia’ just another nasty name or does it have real scientific meaning and therapeutic value? If it is the former, the fact that millions of people have committed suicide because of it is a medical disaster that defies comprehension.

“Schizophrenia” is a medical term which has now, like many others, entered colloquial language. In popular culture the term has been abbreviated to “schizo” or “schizos”: usually used as terms of abuse. The medical coinage of this much-abused term was a distinct historical event and done for reasonable (and more or less innocuous) scientific and medical reasons. This event can be identified, quite literally, as the “first creation of schizophrenia” (but not, of course, of insanity or madness). Despite its subsequent misuses, the name “schizophrenia” was undoubtedly an improvement on the misleading and scientifically unjustifiable term it replaced, “dementia praecox”, which was also created by a known person at a known time. The term “dementia praecox” was coined by the German psychiatrist Emil Kraepelin in 1893 and Eugen Bleuler renamed the condition “schizophrenia” in 1908.

Professor Bleuler, a Swiss psychiatrist, created the term “schizo-phrenia” from the Greek schizo (split) and phren (mind). He believed his neologism better explained the causation of the condition previously described by the eminent German ‘father of psychiatry’, Kraepelin, as “dementia praecox”. The early history of schizophrenia theory is summarised by Professor Irving Gottesman in Schizophrenia Genesis: the Origins of Madness (1991):

“Emil Kraepelin (1856-1926), the famous German clinical psychiatrist, became the definitive categorizer and organizer of the abnormal language and behavior that make up the substance of contemporary psychopathology. Kraepelin’s clinical analyses of schizophrenics stand, for the most part, as the descriptive terms used today. He…gave this comprehensive malady the name dementia praecox. Kraepelin believed that an adolescent who developed hallucinations and delusions, behaved bizarrely, and remained ill in this way for an extended period of time suffered from the illness...Kraepelin defined the disease as a series of clinical pictures with a common feature: termination in “mental weakness”…In Switzerland in 1908 Eugen Bleuler 16

(1857-1939) – contemporary of Kraepelin, Jaspers, Freud and Jung – introduced the term schizophrenia; literally, splitting of the mind. By renaming the disease to focus on a splitting of usually integrated psychic functions (that is, mental associations), Bleuler tried to call attention to the phenomena Kraepelin had downplayed – frequent social recovery and emotionality – thereby avoiding the focus on a relentlessly downhill course and hopeless outcome. He believed that a yet-to-be-discovered toxin caused alterations in the thinking process and disharmony of affect among schizophrenics.” (p.8)

Professor Gottesman’s account of Bleuler’s revision and renaming of ‘dementia praecox’ as ‘schizophrenia’ describes the vital difference between the thinking of Bleuler and Kraepelin regarding prognosis. To Kraepelin the disease inevitably resulted in “mental weakness”; in the words of other authors “according to this view, a schizophrenic who spontaneously recovers has been misdiagnosed in the first place” (Lewine, Bernheim, 1979). Bleuler believed that recovery was possible, suggesting that a third of patients got better, a third remained the same and a third would get worse. This dramatically different recovery rate may have been a reflection of relative kindness in the Swiss asylums (Bleuler) compared to those in Germany (Kraepelin).

It is important to note the fundamental differences (and similarities) between what Bleuler and his contemporaries called ‘schizophrenia’ and how the label is used today. Bleuler described four cardinal features – ambivalence, inappropriate or blunted ‘affect’, abnormal mental associations and auditory hallucinations. The apparent ‘split’ or ‘schism’ was between ‘thought’ and ‘affect’.

The term ‘affect’ has been a key term in psychiatry in the last century and a term I was introduced to in introductory psychiatry lectures at the University of Queensland, when I studied medicine there from 1978 to 1983. ‘Affect’ as used in psychiatry refers to the appearance of a person’s emotional state to a medically trained observer (as opposed to self-reported feelings or ‘mood’). At the same time ‘mood 17

disorders’ (depression and mania) are also called ‘affective disorders’. Rarely is any distinction made, clinically, between ‘affect’ and ‘mood’ – though the understanding the difference between the two is central to understanding concepts like ‘inappropriate’, ‘blunted’ and ‘flattened’ affect – all taught as typical features of ‘schizophrenia’.

“Inappropriate (or incongruous) affect” was described by Bleuler as a cardinal sign of schizophrenia – he gave the example of a person laughing upon hearing about the death of a family member. Of course there can be several reasons for such behavior that are neither inappropriate or incongruous. Maybe the patient disliked the particular family member, and maybe there was good reason for this. Also people sometimes laugh because of shock or surprise. Such reactions cannot reasonably be described as signs of mental illness. Also, in the reality of the medical consultation environment, a person who laughs or smiles during the interview can be judged to be showing “inappropriate affect” if the interviewer doesn’t share the same sense of humour. This is especially likely if the patient is laughing at the interviewer or mocking him or her.

“Blunted” and “flattened” affect are regarded as typical features of “chronic schizophrenia”. They also happen to be the typical effect of the drugs used to treat “acute” schizophrenia. According to psychiatric orthodoxy “acute schizophrenia” is characterized by “positive symptoms” such as hallucinations and delusions, while “chronic schizophrenia” features more “negative symptoms” such as social withdrawal and “downward social drift”, disorganization, loss of self-care and self-esteem, lack of emotional intensity (described as blunted and flattened affect), lack of motivation (“amotivational syndrome”). All these features of chronic schizophrenia can be explained as the long term effects of dopamine and serotonin blocking drugs coupled with institutionalized punishment and torture.

My description of modern psychiatric treatment in Australia’s public hospitals as “torture” may be seen by some as overstating the case. But I stand by this term, and believe that understanding reactions to systematized torture helps explain and understand the mysterious cause of schizophrenia. It can also contribute to talk-oriented techniques that aim to validate rather than deny the torture that psychiatric patients have all endured, but few recognized to be torture at the time they were tortured. Many still don’t. Though if you ask them about it most will have disturbing memories about their first experiences 18

as “inpatients”. Their first induction into the mental health system as administered by the public hospital system.

Nowadays, schizophrenia is described in medical texts as being characterised by delusions and psychosis, however the diagnosis of either is problematic from an egalitarian perspective. Starting with the basic definition of a delusion as a “false belief or set of beliefs” we are confronted with the obvious problem of ascertaining what the true nature of reality is. This is necessary if we are to judge another’s madness on the basis of any criterion other than that it conflicts with our own. The same problem affects the popular definition of psychosis as being “out of touch with reality”: how is ‘reality’ to be determined? Is truth to be determined by common consensus, by expert opinion, by long-accepted traditions, by political or religious dogma or by logical deduction? These important questions of epistemology must be considered before we can reasonably conclude that a person is deluded or psychotic. One doctrine’s delusion is another’s “deep wisdom”.

Fundamental differences in world view and doctrines about the nature of humanity and various aspects of the self characterise different religious, political and philosophical beliefs. These have battled each other for converts and adherents, as well as for moral and political supremacy, over the past several thousand years. It has been common, during this time, for people to accuse others of being mad, insane or deluded. The history of calling one’s opposition “mad” has a long history indeed, one far longer than that of “schizophrenia” or “delusional disorder”, labels that are not much more than a hundred years old.

“Schizophrenia”, “delusional disorder” and “mania” are currently the most commonly used medical terms for those regarded as being seriously deluded, a term equated with psychosis and insanity, irrationality, unpredictability and mental disturbance. Interestingly, ‘insanity’ is considered by the medical profession to be a legal rather than a medical term. This is ironic because ‘sane’, a well-known 19

and frequently used term, is derived from the Latin sanus, meaning “healthy”. Logically, then, the word “in-sane”, i.e., not sane, would refer to an unhealthy mental state, even any unhealthy mental state, making “sane” and “insane” more appropriate terms than other commonly used alternatives for the medical, psychiatric and psychological professions.

Determining who is sane and what beliefs are sane, and who and what are not is nevertheless subject to the same difficulties as questions of irrationality versus rationality, psychosis versus lucidity, truth versus falsehood and others which will be explored in the following pages. In doing so several common assumptions of the medical and psychiatric profession will be challenged. These include the assumption that “schizophrenia” is a “biological illness” and a distinct disease characterised by structural and biochemical abnormalities in the brain; that belief in telepathy is irrational/unscientific and the attribution of subjective experiences to telepathic phenomena is indicative of serious mental illness and psychosis; that schizophrenia and manic-depression are largely genetically determined, and other widely held psychiatric dogmas.

These will be explored regarding absolute and relative truth, while entertaining the possibility that they are partially or totally delusional, or even that they are deliberate misinformation (disinformation). The role of the psychiatric profession as an agent of social and political control will be explored together with the religious, economic and political dogmas which have influenced and sometimes become enshrined and formally structured within the past and present terminology used by the psychiatric profession, especially as they relate to ‘schizophrenia’ and the medical diagnosis of delusions.

It will take detailed analysis, outside the scope of this work, to examine all the currently and recently used psychiatric terminology to determine which of the hundreds of terms are used primarily as stigmatising labels. Different terms are popular in different countries, and, although this work is conceived and written in English, many of the terms used by psychiatrists in English-speaking nations are rooted in other European languages (notably Latin, Greek and German).

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The names by which psychiatric illnesses are known are subject to constant change and creation, which is confusing to doctors and patients alike. Some, such as ‘manic-depression’ are no longer used in textbooks but continue to be used in hospitals, clinics and by therapists, as well as in colloquial language. Others, such as ‘schizophrenia’ are used by the psychiatric profession in dozens of countries, but the reasons for diagnosis vary considerably between nations and the textbook descriptions of what constitutes ‘schizophrenia’ have changed considerably over the past 100 years. They have also become considerably broader, as we shall see; the consequence of which is that more people are eligible for the label, but for very different reasons than when the term was first used in Europe in the early 1900s.

In the 1950s, the criteria for the diagnosis of schizophrenia was broadened considerably spearheaded by the “first rank symptoms” listed by Professor Kurt Schneider of the University of Heidelberg in Germany. During the Second World War this university had enthusiastically embraced the doctrines of eugenics and supported the Nazi German government’s policy of extermination of people labeled as mentally ill. The ostensible objective of this mass-murder was to reduce the “bad blood” in the German and European blood lines. Of course, those who opposed the German government of the day were candidates for such labels of “mental illness”. The German government’s view was that you’d have to be mad not to support Hitler.

The Cold War began with the treaties that ensued following the end of the Second World War and the formation of the United Nations Organization from the vestiges of the League of Nations. The victors of the Second World War placed themselves as the five permanent members of the Security Council, with a mandate to prevent further wars. The World Bank and World Health Organization constituted a triumvirate controlling global politics, economics and health. The modern criteria for the diagnosis of schiozophrenia have been strongly promoted by the World Health Organization. From the 1960s onwards these criteria have been based on Schneider’s First Rank Symptoms.

In 1959, well into the Cold War, Schneider listed 11 symptoms and signs of “schizophrenia”. These included some of the criteria (such as auditory hallucinations) that were in Kraepelin’s initial description of “dementia praecox” and Bleuler’s “four As” (auditory hallucinations, inappropriate affect, ambivalence and abnormal associations). The list also includes several criteria that pathologise experience of or belief in telepathy. These were Schneider’s 11 “first rank symptoms” of schizophrenia, as described in E. Fuller Torrey’s Surviving Schizophrenia: 21

1. Auditory hallucinations in which the voices speak ones thoughts aloud.

2. Auditory hallucinations with two voices arguing.

3. Audiroty hallucinations with the voices commenting on one’s actions.

4. Hallucinations of touch when the bodily sensation is imposed by some external agency.

5. Withdrawal of thoughts from one’s mind.

6. Insertion of thoughts into one’s mind by others.

7. Believing one’s thoughts are being broadcast to others, as by radio or television.

8. Insertion by others of feelings into one’s mind.

9. Insertion by others of irresistible impulses into one’s mind.

10. Feeling that one’s actions are under the control of others, like an automaton.

11. Delusions of perception, when one is certain that a normal remark has a secret meaning for oneself.

Criteria 5, 6, 7, 8 and 9 clearly pathologise telepathy and telepathic interpretations of experiences by patients. They can also be used to pathologise the experience of waking up to the powerful mind- controlling effects of television and radio – two important means of mind control that became ubiquitous in the West during the Cold War.

Drugs that block dopamine have been used for the past 50 years to chemically constrain social and political dissidents in countries around the world. In each country, the political and social environment has determined which people were unfortunate enough to be “treated” with these drugs against their 22

will. Variations in criteria that allow diagnosis of “mental illness” have changed over time, depending on ruling regimes, but the same drugs have been used against social and political dissidents around the world. They have formed a major part of the chemical warfare armoury for several decades, but are still prescribed as “medicines” despite horrific long-term damage to the nervous system. This was first documented over 40 years ago.

The main reasons that dopamine-blocking drugs (‘antipsychotics’/‘major tranquillisers’/‘neuroleptics’) are used in Australia and elsewhere in the modern world are for the treatment of people diagnosed as “schizophrenic” or “manic” and for the control of people considered to be potentially violent, although they are also used to ‘control behaviour’ in children (especially those diagnosed with autism) and the elderly (especially those diagnosed with dementia or senile psychosis). Thus these drugs are mainly used within the psychiatric and prisons systems (and more recently in Immigration Department ‘detention centres’), although recently there have been efforts to broaden the market of major tranquilliser (dopamine-blocker) sales by promoting them for children with “behaviour problems” (other than autism, for which they have been used for several decades) and old people with “sleeping problems”. In these marketing campaigns no mention is made of the connection with other dopamine blockers, or the common risk, as these drugs accumulate in the body, of causing Parkinson’s syndrome, or even worse, “tardive dyskinesia”.

Tardive dykinesia is a grotesque neurological condition that is only known to occur through the use of dopamine-blockers, and has no known cure. It is not amenable to drug treatment, and the drugs used to treat drug-induced Parkinsonism can worsen tardive dyskinesia. This iatrogenic (treatment-induced) disease is characterised by involuntary grimaces and spasms of the face, including uncontrollable protrusion of the tongue, puffing of the cheeks and puckering of the lips (which causes terrible social embarrassment and stigma, together with difficulty talking), and often strange writhing movements (also involuntary) of the hands, arms and legs. Tardive dyskinesia, although more likely with high injected doses of major tranquillisers, has also occurred after small doses used for short periods of time. It sometimes develops following cessation of treatment, but usually occurs after long periods of 23

ingested or injected dopamine-blocking drugs. The condition occurs more readily in the elderly and is not uncommon among residents in Australian nursing homes. It is too frequently seen in psychogeriatric hospitals, centres and clinics in Australia.

In addition to treatment of young people diagnosed with schizophrenia and mania, dopamine-blocking major tranquillisers are also used to control the behaviour of elderly people diagnosed with dementia. Here, as in the young people, the drugs are being used, basically, as chemical restraints. The development of Government-controlled systems allowing forced treatment of (reluctant) “psychiatric patients” in Australia with regular injections of major tranquillisers under the “community treatment order” (CTO) and “involuntary treatment order” (ITO) schemes, has resulted in a situation where all Australians are under risk of being incarcerated and injected with drugs against their will if they entertain ideas or speak about things defined as “psychotic”, “paranoid”, “odd”, “unreasonable”, “grandiose” or “deluded” by the euphemistically named Mental Health System.

In fact, the number of views that Australians are allowed to hold on matters philosophical, scientific, religious and political are rapidly decreasing and the number of “mental illnesses” they are being diagnosed with continues to increase. This includes new labels for “disobedient” children and “overactive” ones, such as the recently promoted “conduct disorder” and “oppositional defiant disorder”. Young people can also be diagnosed as “attention disordered”, “personality disordered”, “thought disordered” and “learning disordered”, as well as “schizophrenic” or “manic”.

“Schizophrenia” and “mania” are said to be characterised by “unusual thoughts”. According to the World Health Organization (WHO)-promoted “Brief Psychiatric Rating Scale” (BPRS), “unusual thought content” is to be suspected in people with “unusual beliefs in psychic powers, spirits, UFOs or unrealistic beliefs in ones own abilities”, and that people who believe strongly in such things are, to put 24

it simply, mad. A range of leading questions are listed for health care workers to elicit these signs of “insanity”:

“Have you been receiving any special messages from people or from the way things are arranged around you? Have you seen any references to yourself on TV or in the newspapers?”

“Can anyone read your mind?”

“Do you have a special relationship with God?”

“Is anything like electricity, X-rays, or radio waves affecting you?”

“Are thoughts put into your head that are not your own?”

“Have you felt that you were under the control of another person or force?”

No wonder people worried about radiation pollution and chemical pollution are afraid to speak their mind. No wonder people don’t talk too much about being under the control of the television programmers or multinational corporations. No wonder people don’t often mention telepathy publicly, though a surprising number do believe in it privately. The above criteria, promoted by the WHO, through a publication prepared by psychiatrists and psychologists at the University of New South Wales in 1995, suggest that people concerned about radiation adversely affecting their health are suffering from “unusual thoughts” (delusions/psychosis). The recommended treatments and the treatments currently employed in Australia, the USA and Britain for “delusional thoughts” are incarceration and injections with dopamine blocking drugs if the “sufferer” refuses to stop talking about their concerns and/or take dopamine blocking drugs of their own accord. This is despite known risks of tardive dyskinesia and other forms of permanent brain damage if the drugs are ingested or injected for any duration of time. Yet if we do not speak our mind, the growing toxin load caused by 25

industrial pollution (including chemical, sound and radiation pollution) will continue to destroy the diversity of life on the planet and threaten the health of the global human population. If we don’t speak up about the dangers of endless televised consumption and capitalism (and the fact that the TV “puts ideas in our minds that are not our own”), human society is destined to follow the role models of greed, consumerism and violence that dominate in the TV world.

Psychiatry, being the medical specialty discipline that controls the development and implementation of national and international “mental health strategies” has a pervasive influence on modern Australian society. This influence is largely unrecognised, but psychiatric theory and practice influence education at all levels as well as prominent media stories, movies, and magazine articles. Even the few stories that are critical of the treatment that psychiatric patients receive tend to validate the stereotypes and diagnoses of psychiatrists (such as ‘schizophrenia’).

The psychiatry profession, with their access to information about dissidents in society has also traditionally played a prominent role in the shadowy area of surveillance and control of “dangerous elements” in society. Of course, how dangerous the citizens of a country are viewed as and for what reasons, depends on the paranoia or otherwise of the governments and public institutions that control the police, military and judicial systems as well as the psychiatric systems of the country concerned. The colonial history of Australia, and specifically the fact that convicts and other “undesirables” were sent by the British Crown to Australia, is pertinent to the development of punitive and repressive attitudes towards the “mentally ill” by Governments in this country as well as by treatment centres and the public generally. This is a complex area beneath which lurks a terrible series of atrocities.

Although Mental Health Acts differ between the States, every State in Australia does have laws prohibiting politically motivated incarcerations, as have been described in the Soviet Union, apartheid South Africa and other politically repressed nations. Such incarceration is, anyway, prohibited by International Laws declared in the 1940’s following the discovery of the extent of and reasons behind the Nazi Holocaust. The reasons behind the Holocaust are complex, but even the most ardent apologist 26

for psychiatric abuses should agree that the eugenics policies that determined who would be killed, and who would be encouraged to breed in an effort to create an Aryan “super-race”, were developed and implemented by men who called themselves scientists, academics, physicians and psychiatrists. Many of the most influential eugenicists were professors in the most respected universities and hospitals in Germany, such as Professor Karl Schneider, who was head of psychiatry at the University of Heidelberg in the 1930s.

Professor Sidney Bloch, a senior professor of psychiatry at the University of Melbourne, in the edited transcript of his 1996 Beattie Lecture at the University, described Professor Schneider’s horrible acts as follows, when warning of the dangers of misused psychiatric theory:

“Karl Schneider held an even more prestigious post as chairman of psychiatry at Heidelberg. Alongside his celebrated academic activities, Schneider contributed energetically to the euthanasia program. A party stalwart from 1932, he became imbued with the Nazi vision, particularly racial hygeine. Ironically he was able to pursue two contradictory pathways. On the one hand he elaborated progressive measures of rehabilitation for the chronically ill and, on the other, participated actively in both the sterilisations and the medical killings. Moreover, he developed a grand plan to establish a research institute dedicated to biological anthropology, launching his studies with the examination of brains derived from the victims of Aktion T4 (other eminent academics also snatched the opportunity to examine the hundreds of available brains).

“The criteria for death were remarkably straightforward: a diagnosis of schizophrenia, epilepsy, senile disorder, intellectual retardation and the like; hospitalisation for 5 or more years; an incapacity to work productively in the mental hospital setting; or not being of German race and nationality (all Jewish patients were killed). The 70 000 patients who met these criteria were shunted off to transit centres in specially disguised buses and thence to one of six special hospitals. Mercy killing was merciless killing. Naked patients were herded into chambers, camouflaged as showers, and gassed with carbon monoxide by hospital staff. Relatives were subsequently informed of the patient’s ‘unfortunate’ death from a medical condition and 27

commiserated with. Killing by gas ended in August 1941, only in the wake of a hard-hitting sermon by Bishop Clemens Von Galen of Munster, a solitary dissenting voice in the Church.” (p.177)

Following the “allied” victory in the Second World War, a radical restructuring of world politics occurred, including the formation of a number of new nations with independent constitutions and governments as well as the United Nations and related bodies, which grew out of the League of Nations, a confederacy of European colonial powers formed after the First World War. Here the term “independent” refers to the ostensible political autonomy granted to many of the countries previously ruled as properties owned by European nations (and often specifically, European monarchies) that had attacked and exploited these lands and people who lived in them, over the preceding 500 or so years. The fundamental abhorrence of such actions is obvious now, as it was to the more enlightened members of all societies over the thousands of years that slavery has occurred, in one form or another.

The “master-slave relationship” is such that the slave must do whatever he or she is told (ordered) to do, and is usually punished for disobedience. Historically, this punishment has ranged from verbal censure to the harshest and most cruel tortures and killings imaginable. Colonial atrocities are the history of every country, and virtually every country has been subject to colonisation or attempts at colonisation by other, usually larger and more aggressive nations. Of course, within these nations, many, indeed the majority, of the population may have disagreed with the principle and practices of the military-backed colonial expansions that the governments and monarchies that ruled them embarked on, but then, as now, voices calling for equality, peace and friendship were drowned out by the amplified rhetoric of war-mongers, profiteers and enslavers.

It is important to realise that the early implementation of eugenics programs was actively supported by distinguished psychiatrists and other doctors in respected academic institutions as well as politicians and social policy developers (including Church leaders) in several nations outside Germany. Australia was one of these nations, along with many others, including the United Kingdom, the United States of 28

America, Canada, Switzerland, Austria, Sweden, Norway, South Africa and Japan. In each country there were differences in the hierarchy proposed, along which lines humans were to be classified and either encouraged to breed or prevented from breeding. There was also a variation in the methods used to prevent young men and women (or children) from parenting children later in life, ranging from the relatively painless to the most cruel forms of mutilation. These included literal castration of young boys diagnosed as “feeble-minded” or “morally depraved”, often for petty “crimes of poverty” or “resistance to discipline”. In the first three decades of this century thousands of boys and men were mutilated in this way according to the stipulations of the first North American eugenics laws in the early 1900s.

The Nazi atrocities were carefully planned and executed, with an elaborate disguise of the “mercy killings” as well as denial, at first, of what was occurring, and, when the evidence was incontrovertible, denial that what they did was morally wrong, or evil. This denial of guilt was repeatedly seen during the Nuremberg Trials, when some of the Nazi war criminals were tried for crimes against humanity. Many who were executed remained defiant to the end, justifying or denying their crime. Yet others were spared justice at the Nuremberg Trials if they were prepared to share their scientific discoveries and research with the Allies or the Russians during the scramble for Nazi and Japanese scientists at the beginning of the Cold War (for more detail, look up Operation Paperclip, conducted by the USA and the notorious MK-Ultra and MK-Delta programs).

It is common knowledge that several senior Nazi scientists, including military scientists and medical scientists were not committed for trial despite devising and orchestrating the murderous euthanasia program and military aggression that the German government embarked on in the early 1930s and continued until the end of the Second World War over a decade later. These scientists were given asylum by the British, American and Russian victors of the war, and given safe passage to, and often ‘new identities’ in, a number of countries, including Canada and Australia. Others were said to have been provided with a ‘safe haven’ in South America, and some in Southern Africa. The asylum of war criminals in Australia is not rumour, however. It is now officially accepted historical fact (although denied for several decades). Many might suppose that the wickedness of Nazi philosophy became a discredited and cruel aberration of the past, and that “Neo-Nazis” are just an inconsequential bunch of skinhead football hooligans in Europe or drunken rednecks in America. This is not the case. 29

EUGENICS AND PSYCHIATRY IN AUSTRALIA

The mental health system in Australia grew out of the asylums of the nineteenth century, which instituted routine, systematized torture of people who were diagnosed as “mentally ill” or “mentally defective”. The general ‘mental defectiveness’ label was applied to people who were also denigrated as ‘lunatics’, ‘criminals’, ‘degenerates’, ‘imbeciles’, ‘idiots’ and ‘feeble-minded people’. Masturbation was viewed as evidence of feeble-mindedness, and disobedience as a sign of degeneracy. Under the first eugenics laws of the 20th century (in the USA) thousands of boys were castrated for “feeble- mindedness” and “delinquency”. The inmates of asylums were forced to work in menial jobs, while the institutions that held them profited from their forced labour. Torture, including flogging, water torture, chaining, and electrical shocks, was routinely administered in these asylums in the guise of “necessary treatment”.

There have been many reforms in the mental health system since then. There is no more water torture, and all therapeutic electric shocks are given under anaesthetic. The huge asylums have been largely replaced by smaller hospitals which are well-staffed and equipped with the best that modern technology can provide. Patients are scanned, bled and given the most expensive treatments on the market, all at taxpayer’s expense. The cornucopia of drugs, include varieties deliverable in a host of forms – there are tablets, capsules, caplets, wafers, syrup, and preparations that can be injected directly into the muscle or vein. Unfortunately, these drugs shorten, rather than extend, the lives of people who are subjected to them. They also cause a chronic state of illhealth.

Eugenics, referring to the science of breeding “better” human beings, has a long tradition in Australia and is deeply embedded in university and hospital doctrines and culture in Australia, particularly in the mental health sciences and the area of public health policy. This is because eugenics was actively supported by Governments in Australia before the Second World War, using the euphemism of “mental hygiene”, with financial support from American and British eugenic societies and wealthy individuals and families, such a the Carnegie family in the US. Other notorious supporters of eugenics were the 30

Rockefellers and Kelloggs. The Rockefeller corporation played a singular role in taking American psychiatry globally. This occurred before the Second World War and accelerated after it.

In Australia eugenic social policy was formulated by academics from the oldest universities, such as the University of Melbourne and University of Sydney, in collaboration with ‘business leaders’ (mainly industrialists) and Commonwealth advisers. The policies paralleled eugenic programs in Nazi Germany, with shared, British foundations. These foundations were inescapably racist and hierarchical, based on assumptions of racial and cultural superiority of the eugenists, depending on the nation in question. Thus the eugenics movement in Japan placed Japanese blood lines at the top of their hierarchy. The Germans placed Northern Aryan blood lines at the top of theirs. In Australia, the situation was more complicated, since eugenics was introduced into the country by races and groups with different ideas about who was at the top of the hierarchy. They agreed, however, on who was at the bottom of the ladder they created: Aboriginal people and those from the Torres Strait Islands.

Accompanying indigenous people at the bottom of the eugenic hierarchy, were (and are) “drug addicts”, “alcoholics” and “the mentally ill”. These people were also inevitably from the poorer sections of society, and the eugenics movement was very much a club for the rich. Rich men were the only people involved in the inner circle of eugenic policy devisers, and many of them were highly respected (at the time) doctors and professors. These men turned a blind eye to their own failings and diagnosed a range of other races, cultures, classes and individuals as defective, constructing names, such as “schizophrenic” to identify them and “euthanase” them. Euthanasia was the name given by eugenists (eugenicists) for the many cruel methods of “mercy killing” employed to rid the world of “defective” and “degenerate” individuals and races.

Eugenic theory first developed in the last years of “legal” slavery by European imperial nations. Nations involved in the slave trade of African people included Britain, France, Spain, Italy, Portugal, Belgium and Holland (Nederlands) in Europe which exported slaves to North and South America (especially Brazil) as well as the West Indies, Cuba and elsewhere. The Governments and monarchies 31

of these countries fought an ongoing war with each other over slaves from what they later termed the “Third World”. Each government sanctioned the taking of children, women and men of all ages forcibly to another country where they were subjected to cruel abuses as well as being compelled to work in captivity. The above nations, many of which obtained slaves from Africa, also were involved in genocide of people in the “colonised” country. The purpose of this genocide was to rid the land of indigenous people and populate it with people loyal to the colonising country. Biological warfare techniques, such as distributing deliberately infected blankets was used in the Americas and in Australia. In Australia there were hideous attempts to genocide the indigenous population and destroy their many beautiful languages. “Half-caste” children were taking away from their heartbroken parents to be trained as housemaids and menial workers in “missions” run by racist white men and women, under the auspices of various Christian churches and an industry developed, intertwined with the Catholic, Methodist and Anglican Churches in particular to organize adoption by good (white) Christian families.

Nazi philosophy assumed that people with “white skin” were superior to those with “black skin”, and the many different hues of humanity were divided into “blacks” and “whites”. This was a central precept of eugenic theory. The experts in the theory further classified people along anthropological lines into different “races” based on Blumenbach’s division of humanity into “black”, “brown”, “red”, “yellow” and “white” races.

Eugenic theory was practiced differently in different countries that passed eugenic laws earlier this century, but the theory inevitably brought atrocities to every nation that embraced this racist anthropo- medico-political theory. This is because eugenics is divided into “positive eugenics” and “negative eugenics”. Positive eugenics involves the encouragement of people with “good genes” to have more children. In Nazi eugenic theory, these people had white skin and preferably blonde hair and blue eyes. These were favoured as aesthetically superior to dark features. It is ironic that images of Jesus of Nazareth, a man of Semitic origin, was portrayed at this time in Nazi sympathising countries as having blonde hair and blue eyes.

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“Negative eugenics” was (and is) centred on preventing those accused of having “defective genes” and “defective blood-lines” from breeding. It is sad to reflect that the Christian Churches did little to prevent the Nazi atrocities of negative eugenics and played a significant role in condoning and aiding the abuse. Children in the care of the Catholic and Protestant Churches in Europe were, at this time, voluntarily given up by Church authorities for negative eugenic treatment. This involved diagnosing these children as “mentally ill” or “degenerate” and sentencing them either to sterilisation or death. Sterilised children were then sold into slavery. Children who were considered unfit to live were killed in a variety of ways by people who called themselves “doctors” and “nurses”. Chemicals were tested on them for toxicity, and drugs and infections were forced into them. The effects of starvation combined with hard labour on people who were being tortured in a variety of ways were studied scientifically by men who called themselves “professors”, “physiologists”, and “medical researchers”.

The Nazi Party also developed a notorious secret police system of “gestapo”, and a social system based on social and familial betrayal. Children were encouraged to inform on their parents in Nazi schools and neighbours were encouraged to spy on each other and report dissident behaviour to the authorities. An intricate system of espionage was accompanied by forced confessions, framing of innocent people with crimes, summary executions, arbitrary arrest, political incarcerations and other features of repressive political systems.

The detailed systems of interrogation and framing by the Nazis was developed by eugenists, many of whom were psychiatrists. Germany already had an international reputation for psychiatry prior to the Second World War. Professor Edward Shorter, in A History of Psychiatry (1997), writes:

“Germany became the world leader in psychiatry during the nineteenth century precisely because of this dispersal of academic talent into many separate universities, each nurtured by the dynastic ambition of its own little principality. Germany possessed some 20 separate universities in addition to two medical academies, each struggling for glory and competing in a lively race for scientific advancement against the others.” 33

Shorter is Professor in History of Medicine at the University of Toronto (Canada) and is a keen supporter of “biological psychiatry”, but even he has to admit to the connection between eugenic evil, Nazism and psychiatry:

“Part and parcel of European culture, the fateful notion of degeneration was picked up by the eugenists, by social-hygienists intent on combating mental retardation with sterilization, and by antidemocratic political forces with a deep hatred of “degenerate” groups such as homosexuals and Jews. Psychiatry’s responsibility for all this is only a partial one. Academic psychiatrists in the 1920s were not generally associated with right-wing doctrines of racial hygiene, though there were exceptions to this, such as the Swiss psychiatrist Ernst Rudin who after 1907 worked at the university psychiatric clinic in Munich, and the Freiburg professor Alfred Hoche who in 1920 coauthored a justification for euthanasia. Academic medicine in Germany on the whole stood waist-deep in the Nazi sewer, and bears heavy responsibility for the disaster that followed. After 1933, degeneration became an official part of Nazi ideology. Hitler’s machinery of death singled out Jews, people with mental retardation, and other supposedly biological degenerates for campaigns of destruction.” (p.99)

In the above passage, Edward Shorter gives a somewhat misleading account of the targets of Nazi mass-murder. The killing was not, in fact, limited to degenerate races, which, by the way, also included “Negroes”, Poles, Russians, Gypsies and other races, in addition to Jews. The Nazis also targetted political dissidents, regardless of race, particularly pacifists, socialists and communists. In addition to the “mentally retarded”, many others of normal and exceptionally high intellect were also sterilised or “euthanased” if they were from the wrong cultural, social, religious or political background. These were generally diagnosed as “mentally ill” with labels such as “moral degeneracy”, “schizophrenia” and “personality disorders”. Shorter also fails to mention that eugenic laws recommending the castration of “mental defectives” were passed in several states of the United States of America many years before the Nazi atrocities, or the widespread acceptance of negative eugenics by British, South African and Australian doctors and academics before and after the Nazi holocaust.

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A unique psychiatric secret police system has been developed in Australia over the past twenty years, under the guise of “The National Mental Health Strategy”. This system has several stated objectives, and has had very different practical results. It is ostensibly designed to “streamline the mental health services”, get institutionalised people into the community, and treat the worsening mental illness problem in Australia. The mental illness problem is said to include “depression”, “anxiety”, “panic”, “schizophrenia”, “attention deficit”, “hyperactivity”, “drug addiction”, “alcoholism” and many others. However, these are names, not cures. There is no known cure for most of the diagnoses promoted by the “Mental Health Strategy”, and the treatment is almost exclusively on treatment with often addictive drugs. Routinely, people who do not want to be drugged are forcibly injected with tranquillisers simply because they refuse to agree that they are mentally ill (termed “lack of insight”) and thus refuse to take drugs voluntarily. The entire psychiatric system in Australia is one where people are given drugs as the sole focus, and punished for refusing to take them. It is drug enforcement of a different type.

Integrated with the psychiatric system in Australia are mobile treatment teams, which visit people at home and ensure compliance with drug taking. These people are trained in “eliciting evidence of mental illness” and are not above fabricating such if they are unable to detect it. They also have the authority to break into peoples’ houses and take them away for treatment in public hospitals with the assistance of State police. No warrant is necessary for such intrusions and the paperwork authorising such actions may be signed by doctors who have never met the person to be taken in for treatment.

These actions are carried out by people who call themselves “health workers” and may be qualified as doctors, nurses, psychologists or social workers. They are systematically programmed into negative eugenics before they are allowed to work in these mobile attack and treatment teams, termed CAT teams. CAT team is an acronym for “Crisis Assessment and Treatment Team”, but inevitably it is the team that creates the crisis. People generally do not react well to being spied on in their own homes and injected with drugs against their will. 35

To orchestrate their widespread slavery program and to control behaviour of the masses as their empire expanded, the British developed extensive policing systems, espionage systems and punishment systems. These were connected with police, the judiciary, prison system and mental health/psychiatry/mental hygeine systems, constituting an intricate system of Commonwealth programs involving people of many nationalities united by loyalty to the British Empire. The objective, during the Second World War, was “contributing to the war effort”. The “manic depressive” Winston Churchill oversaw the profound changes in the British Empire during this time and during the early years of the Cold War. Churchill was both a eugenicist and a senior Freemason.

Various societies of Free Men (as opposed to slaves) existed during the time of open slavery, including the Freemasons in the Protestant World and the Knights of Columbus in the Catholic World. When the USA gained its independence from Britain, George Washington and most of the leaders who signed the Declaration of Independence were Freemasons. In Australia, our first prime minister, Edmund Barton, was a Sydney lawyer and Freemason, while during the Second World War, both Australian Prime Ministers (John Curtin and Robert Menzies) were Freemasons (as was the American president Roosevelt). It is historically evident that the Freemasons were champions of slavery rather than freedom for the masses.

In Australia and the surrounding islands, as well as in South India and China, slavery continued long after African “cargo” slavery was officially abolished (1830-1860). Due to public opposition to slavery, the British referred to the Chinese and South Indians as “coolies” and “indentured labour”. In Australia, after experiments with importing “coolies” from China and India, the governments of Queensland and New South Wales approved the importation of “kanakas”, who were boys and young men who were lured or kidnapped from the surrounding Pacific Islands to work as virtual slaves in the sugar and banana plantations in North Queensland. The practice of “blackbirding”, or stealing/kidnapping Polynesian and Melanesian boys who curiously arrived in canoes to check out the white man’s slaving ships, continued into the early 1900s.

The public opposition to African slavery that resulted in the cessation of this cruel trade grew over the seventeenth and eighteenth centuries, culminating in the official banning of the slave trade and release of slaves from bondage in the 1830s to 1860s. The Commonwealth slavers in Australia and Asia were 36

not to be so easily stopped, however, as by an International Ban on slavery. As Myra Willard wrote, in The White Australia Policy to 1920:

“The stringent enforcement of the international treaties which aimed at the extinction of the African slave trade caused many in tropical lands who had become dependent on this form of labour to look to Asia for a substitute.”

This substitute included Chinese and Indian “coolie labour”, according to Willard, but the whole story of the evolution of British and Australian Commonwealth slave theory and practice has been far more complex and persistent than Willard’s book reveals. In fact, the British Commonwealth’s system of slavery included all the countries in the British Empire, including Australia. Not all the Empire’s countries were treated as harshly as Australia was, however. And this harsh treatment of Australia and its residents by agents of the British Commonwealth in Australia has continued to this day. Involved in this abuse of the Australian population are the numerous secretive police/psychiatry organisations currently active in Australia, several of which have direct links with the British Commonwealth.

The centre of the British Empire was London, and this was also the centre of the British slave trade. The concept of the “Commonwealth” was devised by social theorists, politicians and academics at the University of London and also at the Oxford and Cambridge Universities. These Universities became an essential part of British foreign policy during the time of open slavery, as well as in the times of disguised slavery which followed. Brainwashing, involving indoctrination into the academic system of “doctors”, “degrees”, “honours” and other titles were bestowed on students of the system creating a persistent and highly authoritarian academic hierarchy. This system was exported to the colonies, where an uninterrupted tradition has continued to the present day.

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In the academic system, as in the police system and military, obedience to the chain of command was ensured by a hierarchical system of titles. In the University and hospital system this hierarchy was headed by “professors”, who had authority over “associate professors”. These had authority over “senior lecturers”, who could pull rank on “lecturers”. Lecturers were above tutors and tutors had “superior rank” to students. Senior students were viewed as superior to junior students in this system, which also encouraged the entire academic institution to compete with and look either up to or down at other academic institutions. A similar mentality was encouraged in Church owned high schools in England and the British colonies, in which schools and universities were built by the British which repeated the same hierarchical system, often with individual perversions of the British model.

The mind police systems devised by the colonial system in Australia involved a poorly integrated system of police, prison and health departments, together with departments designed for “social welfare”, the “protection of natives”, “migrant policy” and the “corrections system”. The police departments included officers whose duties were to keep the peace amongst the Australian immigrants and convicts as well as “native police”. The immigrants included free men and women who emigrated to Australia from England, Scotland and other “white” nations, and also a smaller number from China. In the 1860s, when the first large public hospital asylums in Australia were built to service the goldrush, the police had to keep the peace between Chinese and European immigrants on several occasions. Many people were locked up and pushed for suffering from “gold fever”, a madness characterized by inordinate love of or manic/paranoid/persecutory delusions about gold. The treatment was to give them a good whipping. Whipping the madness out of people was a cure-all back then.

Gold mania (also called “gold fever”) was, alongside dipsomania (alcoholism), the main diagnosis used to incarcerate Victorians in the 1860s and 1870s, according to psychiatrist Eric Cunningham Dax in his 1961 book, Asylum to Community. On page 14 he wrote:

“Victoria’s first mental hospital was opened in 1848 at Yarra Bend, in Melbourne, and designed on the lines of a gaol, but afterwards some prefabricated wooden buildings, imported from England, were erected on the spot to increase the accomodation. 38

“The gold-rush began in 1851, but by the middle sixties it was trailing off, as much of the surface gold had been mined so there were large numbers of restless, disturbed and often drunken individuals who must have been a considerable problem to the government. Partly because of the needs of the population, and perhaps mainly because of the unemployment, two new mental hospitals were put up at that time, one in the western part of the state on the goldfields at Ararat and the other in a rich gold-mining district at Beechworth in the north- east.”

Lust for gold has played a major role in the development of social policy in Australia, and Victoria in particular. The White Australia Policy, that embarrassing legacy of British colonial racism, was itself devised in the 1860s to prevent Chinese exploitation of the newly discovered gold in Australia, among several reasons, all racially and culturally discriminatory. The indigenous people of Australia were not even recognised as human by the first English colonists who declared Australia to be terra nullius (uninhabited land). This is despite over two hundred years of prior European knowledge that the Southern Land was indeed populated with a race of dark-skinned people who spoke several different languages. More recently, it has become evident that they spoke several hundred different languages. From the English point of view, however, it did not matter what or how many languages they spoke: they were all just “natives”, who were equated with “savages”.

The treatment of those deemed to be “savages” was indeed savage. Genocide of Aborigines in Australia was committed through several techniques resulting in the mass murder of hundreds of thousands, possibly millions, of men, women and children of all ages. Some were taken as slaves, but most were killed mercilessly, mostly through poisoning (chemical warfare) and infections (biological warfare). Infants and young children were taken forcibly from their families and biological parents to be brought up in orphanages and foster homes, or enslaved as ‘domestic servants’. Their parents were subjected to arbitrary arrest and arrest for “crimes” of poverty. Alcohol was used by the colonists to stupefy “natives” in many lands, including Australia. These natives included aboriginal people as well as native Australians of European ancestry. Alcoholism is still rife in Australia generally and it is of 39

note that the early psychiatric hospitals were full of people with alcohol-related problems. It is also of note that alcohol was the first British “currency” in Australia.

In Australia, alcohol was used as a direct weapon for genocide of the aboriginal population by the British in a similar way to that in which opium was used in the “opium wars” against China and India. In these wars, which occurred in the early and mid 1800s, Indian, Burmese and Bengali farmers were forced to dig up their rice fields by British colonial rulers and plant their homelands with opium poppies. The opium was then pushed into Chinese society with the intent of addicting and subduing the Chinese population. When the Chinese Government attempted, in the 1840s, to halt the opium trade, the British threatened to attack Chinese cities with battleships poised outside Chinese ports. Hong Kong was ceded to the British for the period of 150 years after this shameful act of international terrorism and drug warfare. Shortly afterwards, and in the wake of the British success, the USA demanded similar trade concessions to the British from China and maintenance of their own opium export industry to the most populous nation on earth. It is of note that enforcement of “free trade” was the justification the British Government gave to its people, for what later became known as the “opium wars”.

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SCHIZOPHRENIA AND DOPAMINE BLOCKERS

“Schizophrenia” was invented in 1908 by the Swiss psychiatrist Eugen Bleuler (1857-1939), who crafted diagnostic criteria for this “mental illness of young people” from the condition termed “dementia praecox” by the German psychiatry professor Emil Kraepelin (1855-1926) in the 1890s. Michael Stone, in Healing the Mind, writes:

“Succeeding Forel as the director of the famed Burgholzli clinic in 1898, Bleuler worked intensively with psychotic patients, visiting and talking with them five or six times a week, such that his familiarity with them was comparable to that of psychoanalysts with their patients (who were also seen about five times a week in this era). His great monograph on the group of schizophrenias appeared in 1911; here he proposed a new definition of the condition Kraepelin and others had been calling dementia praecox. Bleuler identified the “primary signs” of this condition, which have become known as the four “A’s”: autism, loosening of associations, ambivalence, and affect inappropriateness. The latter trait was the key element for Bleuler: The patient who smiled while talking of the death of his mother, or who cried while talking of inheriting a fortune, was showing a split (Greek: schizo) between thought and affect: hence his term schizophrenia. Ambivalence and autism were also words Bleuler coined.” (p.146)

Using the word ‘language’ broadly, it is difficult to see how ‘autism’ (inability or refusal to speak) and these other abnormalities could be detected in people who do not speak the same language as the diagnoser. How does one tell if a person’s mental associations are ‘loosened’ when they have a completely different belief system, mode of speech and conceptual framework; when they think and speak in another language? It is easy to judge smiling or crying “inappropriately” as suggestive of madness evidenced by “inappropriate affect” if the reasons for such emotions are not understood due to linguistic, social and cultural differences and barriers or due to failure to understand the individual experiences of the patient. It is equally unclear as to how injections or tablets of dopamine-blockers can improve such ‘symptoms’. 41

There have been many changes in the accepted criteria for diagnosis of schizophrenia in the modern world, however, and considerable differences exist in different parts of the world. This is mentioned in the World Health Organization’s “Handbook for the Schizophrenic Disorders” (1995), which was written by Heidi Sumich, Gavin Andrews and Caroline Hunt of the “Clinical Research Unit for Anxiety Disorders” of the University of New South Wales at St Vincent’s Hospital, Sydney and “underwritten” by the New South Wales Institute of Psychiatry:

“There is no single specific symptom that is required for a diagnosis of schizophrenia. In other words, the symptoms experienced by one person may not be exactly the same as the symptoms experienced by another person. However, as a group, people with schizophrenia display an identifiable set of symptoms. If someone exhibits one or more of these symptoms for a specified length of time, he or she may then be regarded as having a diagnosis of schizophrenia.

“The American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) is the alternative major diagnostic classificatory system to ICD-10 [the World Health Organization’s “International Classification of Diseases”]. In DSM-IV, the diagnostic criteria for schizophrenia differ slightly [!] from ICD-10 in relation to the duration of time for which symptoms are required to have been present prior to diagnosis. DSM-IV requires a minimum duration of six months, including a prodromal or residual phase, while ICD-10 requires the persistence of symptoms for only one month.”

The handbook continues to explain how these “symptoms” of schizophrenia are to be elicited, claiming that “the most important symptoms and signs” include “hallucinations”, “delusions”, “thought disturbances”, “disordered thinking” and “negative symptoms” (these are very different to Bleuler’s criteria). Detailed methods for acquiring evidence of these “abnormalities” are given in the Handbook for the Schizophrenic Disorders, which was distributed to health workers in Australia by the Belgian drug company Janssen-Cilag, which manufactures several drugs for the treatment (but not the cure, which is said to be impossible) of “schizophrenia”, including the crippling dopamine-blocker haloperidol, which is marketed as injections, syrup and tablets of Haldol. This drug has been used around the world for the punishment of social and political dissidents over the past 50 years. The 42

manual contains a series of questions and interpretations for doctors and other health workers designed to increase both diagnosis of ‘mental abnormality’ and treatment with Haldol and related drugs, and for the most dubious of reasons. Injections and coerced ingestion of Haldol have resulted in literally millions of people being crippled with tardive dyskinesia and other forms of chronic brain damage since the 1960s. Others have died from overdoses (deliberate or unintentional) of Haldol.

The Handbook for the Schizophrenic Disorders contains a dangerously over-inclusive set of diagnostic criteria known as the “Brief Psychiatric Rating Scale” (BPRS). In it, “hallucinations” are described as “seeing, hearing, smelling, or tasting things that other people do not see, hear, smell, sense or taste” [which could be due to greater sensitivity] and are to be elicited by the following questions:

“Do you ever seem to hear your name being called?”

“Have you heard any sounds or people talking to you or about you when there has been nobody around?”

“Do you ever have visions or see things that others do not see? What about smell odors that others do not smell?”

It is easy to see why “schizophrenia” was not diagnosed in Biblical times. All the prophets and visionaries, including Jesus Christ, would have been committed for involuntary psychiatric treatment. People who believe that they are Jesus Christ rate a special mention in the manual, for these people are suffering from the typical delusions of schizophrenia:

“Delusions [are] false beliefs that are firmly held despite objective and contradictory evidence, and despite the fact that other members of the culture do not share the same beliefs; for example, the person may believe that he or she is Jesus Christ, or that he or she is being followed, poisoned, or experimented upon.”

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What about the people who are being poisoned and experimented on by the psychiatric industry itself? These people can expect a diagnosis of “delusions” after being asked the following questions, which are apparently indicative of “unusual thought content” if answered in the affirmative:

“Have you been receiving any special messages from people or from the way things are arranged around you? Have you seen any references to yourself on TV or in the newspapers?”

“Can anyone read your mind?”

“Do you have a special relationship with God?”

“Is anything like electricity, X-rays, or radio waves affecting you?”

“Are thoughts put into your head that are not your own?”

“Have you felt that you were under the control of another person or force?”

“Bizarre behaviour”, another “sign of schizophrenia” is to be detected by asking:

“Have you done anything that has attracted the attention of others?”

“Have you done anything that could have gotten you into trouble with the police?” [the word “gotten” betrays an American origin for the BPRS]

“Have you done anything that seemed unusual or disturbing to others?”

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In the “Brief Psychiatric Rating Scale” (attributed in the manual to the World Health Organization though it was actually developed by the US Department of Veterans Affairs in the 1960s) is a description of “self neglect” which is conservative, to say the least. A rating of “2” for “self neglect” is to be recorded for “hygiene/appearance slightly below usual community standards, e.g., shirt out of pants, buttons unbuttoned, shoe laces untied, but no social or medical consequences”. A rating of 3 (out of 7, which is “extremely severe”) is merited by “hygiene/appearance occasionally below usual community standards, e.g., irregular bathing, clothing is stained, hair uncombed, occasionally skips an important meal” with “no social or medical consequences”. To be “mentally well” the manual insists that we should be eating “three meals a day”, which many Australians cannot afford, and many others choose not to consume. This strange obsession with regular meals is repeated in “grade 4 self-neglect” which is to be recorded by the “health worker” if a person “fails to bathe or change clothes” or is thought to have, “clothing very soiled, hair unkempt, OR irregular eating and drinking with minimal medical concerns and consequences”.

It is difficult to see how genetic defects and chemical imbalances can be blamed for failing to tuck one’s shirt in one’s pants, and eat three meals a day. In addition, the handbook contains a single-paged table on which the level of severity (from a ‘mild’ 2 to a ‘very severe’ 7) of 24 symptoms and signs elicited by the leading questions can be formally recorded by the “health worker”. The forms are suitable for analysis by a computer, and provide a checklist of “abnormalities” to detect. These include: somatic concern, anxiety, depression, suicidality, guilt, hostility, elated mood, grandiosity, suspiciousness, hallucinations, unusual thought content, bizarre behavior, self neglect, disorientation, conceptual disorganization, blunted affect, emotional withdrawal, motor retardation, tension, uncooperativeness, excitement, distractibility, motor hyperactivity, mannerisms and posturing.

“Suspiciousness” is to be elicited by the following questions: 45

“Do you ever feel uncomfortable in public? Does it seem as though others are watching you? Are you concerned about anyone’s intentions toward you? In anyone going out of their way to give you a hard time, or trying to hurt you? Do you feel in any danger?”

For those who study psychiatry professionally, meaning they first gain medical degrees from recognised universities, further training in techniques of interrogation are obligatory, always seeking evidence of “mental illness”. The recommended undergraduate textbook in Psychiatry for medical students in Melbourne is Foundations of Clinical Psychiatry written in collaboration between psychiatry professors at the University of Melbourne and Monash University, and published in 1994 by Melbourne University Press. In the chapter titled “the psychiatric interview and evaluation of the mental state” Professor Nicholas Keks explains how persecutory delusions can be inferred and that they are not necessarily untrue to qualify as “delusions” (reflected also in the “psychiatric truism” that “a delusion is still a delusion even if it transpires, by coincidence, to be correct!”):

“Delusions with religious or subcultural content can prove difficult to assess. Usually consultations with a member of the patient’s social group is necessary. It should also be kept in mind that what appear to be persecutory delusions may be true. It is not whether the delusion is absolutely false that is relevant, but rather that the belief is adhered to by the patient very firmly despite manifestly insufficient or inappropriate evidence. For instance, a man was convinced that his wife was having an affair, and indeed she was in a secret relationship. However, the husband’s conviction arose from the interpretation he placed on entirely unrelated events such as the numbers printed on the letter he received from the tax office.

“In eliciting delusions, it is useful to first ask a question which should elicit a positive response from anyone, and then to probe further for abnormal thought content. For instance: ‘Do you ever feel self-conscious or shy in a new place or with strangers?’ The answer should be ‘yes’ if the question was understood. Then the patient can be asked whether they worry if people laugh behind their back, and so on, progressing to ask about organised persecution.” (pp.73-74)

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It is assumed that belief in “organised persecution” is indicative of serious mental illness: namely “schizophrenia”. What of hundreds of years of organised slavery and other colonial atrocities? Did these end with the official abolition of slavery by the French in 1794? Or by the British in 1834? Or by the United States of America in 1863? Or by the Belgians in 1904? Did organised persecution of Australian aborigines end with the banning of “blackbirding” (kidnapping of Aboriginal and Islander slaves) in 1874? Was the 1940s persecution and mass-murder of people diagnosed as “schizophrenic” in Nazi Germany “disorganised”? What about the diagnosis of “sluggish schizophrenia” in Soviet political dissidents during the 1960s and 1970s?

Rather than looking for the social, political and historical origins of schizophrenia, the Mental Health Research Institute (MHRI) in Melbourne is, in addition to conducting an extensive “genetic study of schizophrenia”, actively engaged in trying to establish “biological abnormalities” in diagnosed “schizophrenics”. The focus of the work of the “Molecular Schizophrenia Division” is on the neurotransmitters dopamine and serotonin. The institute’s 1997 Annual report explains:

“Dopamine is a chemical within the brain which is thought to be important in the pathology of schizophrenia. The major evidence for this is that drugs which behave like dopamine in the brain can cause a psychosis reminiscent of schizophrenia in non-schizophrenic individuals. In addition, the antipsychotic drugs that are used to treat schizophrenia reduce the activity of dopamine in the human brain. Together, these observations suggest that over-activity of the dopamine neuronal pathways are important in the pathology of the illness.” (p.18)

In other words, because dopamine-blocking drugs which have been forced into people to “treat schizophrenia” (and mania) for several decades affect this particular neurotransmitter, dopamine must be at the root of the postulated “biochemical imbalance” in this “illness”. It is a deft reversal of logic, and if “statistically significant differences” were discovered it would be very difficult to ascribe “dopamine receptor abnormalities” to the illness rather than the treatment. As it turns out, after 47

examining many brains from dead “schizophrenics”, the researchers were unable to pronounce any difference between theirs and those of “normal people”:

“Within the Molecular Schizophrenia Division there are a number of strategies being employed to determine whether dopamine is involved in the pathology of schizophrenia. Tabasum Hussain and Susie Kitsoulis have measured the density of dopamine receptors in samples of brain tissue obtained from subjects who have had schizophrenia [with their permission?] and compared these measures from individuals who have not had schizophrenia. There was no difference in dopamine receptor quantities in either the caudate putamen or frontal cortex of subjects with schizophrenia. In addition, Robyn Bradbury has shown that there is no difference in dopamine receptor numbers in the hippocampus of people with schizophrenia. Our data have shown that dopamine receptor quantities do not appear to be altered in the brains of subjects with schizophrenia.”

Not daunted by yet another failure to demonstrate actual abnormality in the brains of people diagnosed as “schizophrenic”, the MHRI is also investigating “serotonin neurobiology and schizophrenia”, again because drugs which are used on people labelled “schizophrenic” affect this neurotransmitter, which is also the focus of a marketing campaign for new antidepressants. Here the institute claims to have had some success, but also plans to make some ridiculous inferences from studies on rats:

“Developments are being made on what cause the changes in the serotonin transporter in subjects with schizophrenia. Lee Naylor has discovered that by injecting rats with a drug called 5,7-dihydroxy tryptamine, she can cause changes in their serotonin transporter which are similar to those we have seen in subjects with schizophrenia. If her early findings are confirmed, then this may provide a model by which the changes in the serotonin transporter in the human brain can be studied using rat brains.” (p.19)

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In a situation repeated in all the large research institutions in Australia, most of the repetitive, often meaningless, sometimes dangerous work which includes handling potentially infectious tissue samples is done by young women, often of “ethnic background”. The Board of Directors, however is consistently middle aged, all-white and heavily male dominated, with usually one or two token “female board members”.

The “Chairman” and “Company Director” of the Mental Health Research Institute, which received “grants” totalling $5,484,523 in 1997, was Professor Ben Lochtenberg, qualified with a Bachelor of Engineering (BE), and medically unqualified. He was also Chairman of ICI Australia (Imperial Chemical Industries), Director of Capral Aluminium and a Board Member of the Inner and Eastern Health Care Network. He was a “member of the University of Melbourne Council and the former Chairman of the Ministerial Review of Medical Staffing in Victoria’s Public Hospital System” according to the 1997 Annual Report. All 14 members of the Board of Management in 1997 were white, and 12 were male. They included one professor of psychiatry (David Copolov, the Institute Director), one professor of medicine (Robert Porter, who is also Board Member of the Southern Health 49

Care Network and Member of Council, Victorian Institute of Forensic Medicine), a professor of surgery (Gordon Clunie, a Scottish surgeon, now retired), three lawyers, an accountant (who is treasurer of the institute) and an economist. The female members were Dame Margaret Guilfoyle, who is described as “Deputy Chairman of the Infertility Treatment Authority, Chairman of the Judicial Remuneration Authority and Board Member of the Children’s Television Foundation” and Dulcie Boling, who is described in the 1997 Annual Report as “Director of Seven Network, Mercantile Mutual Holdings Ltd, Multi Media Asia Pacific Ltd and Country Road Ltd.” Dame Guilfoyle also is the former Chairman of the “Human Rights Commission Inquiry into Rights of People with Mental Illness.” One might wonder, from the Annual Report of the MHRI, how closely the Board Members of the institute identify with the problems of the oppressed and dispossessed in Australia. Unless we are to imagine that in our “free country” no one is oppressed or dispossessed.

Since then, the MHRI has been led by Professor Colin Masters, previously head of laboratory research at the institute. Though no longer headed by an explosive and cyanide magnate, the direction of the MHRI has changed but little. The focus remains on the development of new drugs and broadening therapeutic justifications for older ones; the idea of looking holistically at the cause of mental difficulties and their treatment is alien to this paradigm.

In addition to their studies on schizophrenics’ brains and those who died with Alzheimer’s disease, the MHRI is also involved in the “Clozaril Patient Monitoring System (CPMS)”, which, according to the institute’s report, is an “independent monitoring system” established by the Mental Health Research Institute. It is funded by Novartis Australia. Novartis (which also markets Ritalin for “attention deficit/hyperactivity disorder”) is the only company that sells Clozaril (clozapine) in Australia. The reason it needs to be closely monitored is that clozapine is a very toxic drug, as the report admits, whilst maintaining that it is a good drug for refractory schizophrenia:

“Clozapine is an atypical antipsychotic agent of the dibenzodiazepine class of compounds. It is chemically and pharmacologically distinct from standard antipsychotic drugs and has been shown to improve both the positive and negative psychotic symptoms in many patients with schizophrenia who are unresponsive to, or intolerant of present day therapy, while producing minimal extrapyramidal side effects. 50

“Unfortunately, clozapine can cause a life threatening decrease in the number of white blood cells (usually the neutrophils) in some people. At present there is no way to determine who may be at risk from this effect, but it is known that anyone who has experienced this problem cannot be exposed to the drug again.”

The toxicity if the drug is such that:

“Everyone using clozapine must have a weekly blood test for the first 18 weeks of treatment, and then blood tests must be performed no less than every 28 days thereafter.”

Agranulocytosis is not the only problem clozapine can cause. The 1999 MIMS lists: agranulocytosis, granulocytopenia, other haematological disturbances, fatigue, drowsiness, sedation, dizziness, headache, weight gain, hypotension, tachycardia, transient pyrexia (fever), extrapyramidal symptoms (such as Parkinsonism), seizures, neuroleptic malignant syndrome (another potentially fatal adverse effect), dream intensification, hypersalivation, hyperthermia and others.

The 1996 American Publication Inside the Brain, by Pulitzer prize-winner Ronald Kotulak, purchased from the Monash University Bookshop, makes no mention of these problems. Kotulak, an enthusiastic promoter of any and all the drugs mentioned in the book, gives clozapine his unbridled support:

“Unlike the standard antipsychotic drugs and tranquilisers, which often render patients dulled and sedated, the new medications leave them clearheaded.

“One such drug is clozapine (Clozaril), which dampens explosive aggression and clears psychotic thoughts. At places like the Mendota Mental Health Institute in Madison, Wisconsin, clozapine has swung open the doors of the back wards, allowing patients once doomed to a lifetime under tight security to move into the community, going to school and work. 51

“Doctors who have seen the drug’s effect are enthusiastic. “It’s like these people were living under a spell and clozapine is breaking the spell,” said Dr.Gary J. Maier, of the University of Wisconsin, and director of psychiatric services at Mendota, which houses the state’s most violent patients. “When that happens the long-standing immature personality that had been struggling to be healthy – but couldn’t because it kept going crazy – is freed. They start to grow up.”

“Harvard’s Dr. John Ratey, who treats Massachusetts’ most violent criminals at Medfield State Hospital, also is sending some of his patients home after putting them on clozapine. He called it “the most exciting new drug I’ve ever seen” and likened its effect to “a guided missile that goes right to the site of aggression in the brain without making patients stupid, apathetic, sleepy, or non-sexual”. (p.88)

By inference, the “usual drugs” used for “psychotic disorders” do cause these problems. Ronald Kotulak, a science reporter, was not commissioned by the editor of the Chicago Tribune to criticise the new drugs but to praise them, and to find out “Why do some children turn out bad?” This question is the motive given in the introduction, anyway, and the answer Kotulak provides is simplistic and misleading: “brain chemistry” accompanied by being brought up in “bad neighborhoods”. When he describes these “bad neighborhoods” as being characterised by poverty, single mothers, and lower education and income levels it becomes clear that “black neighbourhoods” fit his description of “bad neighbourhoods”. It is also evident that several pharmaceutical companies stood to benefit from his book, particularly Novartis, the manufacturers of Clozaril, and the makers of the new antidepressants, including Eli Lilly, manufacturers of Prozac, which is promoted several times in the book.

A key factor in the “chemical imbalance” theories propagated by Kotulak and the marketing strategies for new antidepressants is blaming the neurotransmitter serotonin for a ludicrous range of “mental illnesses” and “mental abnormalities”. Conveniently, the new SSRI (Selective Serotonin Reuptake Inhibitor) drugs are known to primarily affect serotonin metabolism. With scant regard for scientific evidence, Kotulak writes: 52

“Low serotonin is common to many mental problems in which one or more of our drives bursts out of its chemical corral.

“Medical researchers found that most of these disorders may be treatable with drugs that change serotonin levels. First developed to halt the uncontrollable aggression of schizophrenia and depression, these drugs are now being used or tested for a wide variety of problems, including alcoholism, eating disorders, premenstrual syndrome, migraines, anger attacks, manic-depressive disorder, obsessive-compulsive disorders, anxiety, sleep disorders, memory impairment, drug abuse, sexual perversions, irritability, Parkinson’s disease, Alzheimer’s, depersonalization disorder, borderline personality, autism and brain injuries.” (p.88)

This gives some indication of the widespread experimentation that has occurred since SSRI drugs were developed. They were developed, however, as ‘antidepressants’, not ‘antipsychotics’ or ‘anti- parkinsonian drugs’. The list above, rather than demonstrating a ‘low serotonin’ aetiology, merely shows that when a new psychiatric drug is developed the medical profession tends to experiment widely with it, ‘trying it out’ on patients with a range of different problems. This has occurred with the whole spectrum of psychiatric drugs, including ‘minor tranquillisers’, ‘major tranquillisers’, lithium, ‘antidepressants’ and amphetamines. In fact, if one looks at the history of medical chemical discoveries, such as the discovery of new hormones, one of the routine targets for experiments have been psychiatric patients. Thus, the discovery of insulin in 1921 was followed the next year by trying out “insulin-comas” as a treatment for the insane. Cocaine, heroin and amphetamines were widely used by the medical profession at the beginning of the 20th century prior to them being designated (illegal) dangerous drugs. Indeed cocaine, heroin and amphetamines are dangerous drugs, but so are dopamine- blockers (‘antipsychotics’), benzodiazepine (‘minor’) tranquillisers and alcohol. Nicotine is also a dangerous drug, and so is Prozac. All these drugs have caused deaths – directly and indirectly.

All these drugs (except nicotine and alcohol) were introduced to the world’s human population by the medical profession, and all have been deliberately injected into experimental animals to test their toxicity. These animals have included mice, rats, cats, dogs, sheep, goats, monkeys and chimpanzees. With complete insensitivity towards the suffering of our closest primate relatives, chimpanzees have 53

been force-fed alcohol (to cause cirrhosis) and fitted with masks that forced them to inhale cigarette smoke; they have been deliberately infected with human pathogens and psychologically traumatised so that scientists can “tell us more about human illness”. It is assumed that by finding out more about illness we will simultaneously understand how to cure and prevent it – and that this end justifies the unpleasant means (of creating illness in animals). This is a complex issue, and many hold that the suffering and ‘sacrifice’ of animals is vital for medical progress and the development of scientific knowledge.

Most of the animals killed by the scientific establishment in Australia (and the world) today are not being sacrificed for a ‘good reason’. They are being tortured and killed because they are victims of a lucrative multi-billion-dollar industry. This industry breeds animals just so that they can be experimented on – using modern genetic technology and knowledge rats, mice, rabbits and other animals that are genetically vulnerable to cancer and infections are being bred so they can be studied after exposing them to various stressors and then killing them. The publication of research findings, inevitably ‘non-conclusive and requiring further (animal) experimentation’ is itself a multi-billion- dollar industry as is the ‘medical research training industry’. They are not trained to bite the hand that feeds them.

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A PSYCHOANALYSIS OF PSYCHIATRY

In recent years, many psychiatry departments in Australia have changed their name to “departments of psychological medicine”, however, over the past 100 years, the philosophical, political and theoretical divide between “psychology” and “psychiatry” (a medical specialty) has been deep, and in many ways irreconcilable. It remains the case that genuine psychology (scientific knowledge of the mind) and healing psychiatry (medical treatment of psychological problems) cannot be achieved without a complete transformation of both disciplines. It will require more than changes of name. It will need a change from a system of labels, statistics, punitive treatments, patriarchal attitudes and hierarchies to one where the complexity of different cultures and individual perspectives is understood and valued. It is hoped that the new systems of psychiatry and psychology are more open, egalitarian and democratic than those of the present, which tend to be secretive, ruled by “old boy clubs”, prejudices and negative preconceptions about “psych patients” (now officially called ‘clients’ and ‘consumers’ of the ‘Mental Health Services’). In Australia the domination of psychiatrists over psychologists is obvious, especially in the hospital system. It is a sad reflection of the state of the psychology profession that from being a breeding ground for pertinent criticism of the medical model and commonsense (and logical) alternatives to labels and drugs, in Australia, graduate “clinical psychologists” are often as certain of the validity of psychiatric labels as they are about the miraculous nature of modern psychiatric drugs.

Psychology, meaning knowledge about the mind, has become increasingly splintered over the years into different schools of thought, each with different approaches, assumptions, theories and research methods. They also have different beliefs about the brain, ranging from schools of thought which argue that all behaviour is caused by chemicals in the brain to ones that argue that the brain has little to do with thinking or the destiny of individuals, which is preordained by “karmic forces” and “past lives”. Other schools of psychology argue that all (or most) adult psychological distress is related to early childhood traumas, or that psychological problems are usually caused by genetic defects and susceptibilities, or the aftermath of viral infections. Some schools of psychology are preoccupied with statistical analyses of behaviour, others consider these a waste of time and focus on developing 55

“personality tests” and “intelligence tests”. Some of the more outrageous psychology schools ascribe what others interpret as “psychopathology” to alien abductions and channeling by extraterrestrials and “metaterrestrials”. Many recent schools of psychology are heavily involved in animal experimentation, including the torture of mice, rats, cats, dogs (a favourite) and monkeys, from which often unreasonable inferences are made about human thought and behaviour. Some just focus on giving good advice, concentrating on empowering individuals to make realistic, sensible choices and decisions, and to find solutions to problems through their own creative thought and personal motivation. Some schools of psychology are predictably more scientific than others, some are more philosophically sound and therapeutically effective than others.

Psychology is a broad field of study, which developed from “the arts” and philosophy, rather than from “science” and medicine, a point which has led to intense rivalry between adherents of psychology and those of psychiatry over the years, with “psychiatry”, as a branch of “medicine”, claiming a mantle of scientific superiority over “unscientific psychology”. In truth, however, neither is founded on firm scientific ground, though both have tried hard to appear “scientific”, often by quoting statistics and engaging in scientific-sounding “double-blind trials” and “clinical trials”.

Although Sigmund Freud and other early psychiatrists were medical doctors trained in neurology, they focused on disturbances of thinking as well as dynamic processes affecting the development of the mind generally, often using anecdotal and personal experiences as a basis for their theories. Freud developed the concept of the “unconscious”, arguing that much of an adult’s behaviour is governed by largely unrecognised unconscious motives. These required many years of analysis by an expert psychiatrist (such as himself) to gain insight into. The dependence, and other undesirable results of such prolonged “talk therapies” were themselves given names, like ‘transference’, in the new jargon. This jargon grew in the new “scientific discipline” of “psychoanalysis” and the practitioners of this style of psychiatry were (and are) called psychoanalysts.

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Literally speaking, “psychoanalysis” refers to analysis of the mind, and in this sense it is an essential prerequisite for understanding the mind and improving mental health in individuals and society as a whole. In practice, however, the therapeutic value of psychoanalysis is dependent on the theoretical assumptions of the psychoanalyst: how the psychoanalyst thinks other people think. This includes assumptions about others motivations and the dynamic processes that shape the mind’s development throughout life. Behaviour, the observable result of others’ mental activity can be interpreted in different ways depending on the assumptions, beliefs, hypotheses and theories of the analyst, and can also be misperceived because of prejudices of the analyst.

It is also inevitable (and probably desirable), that psychoanalytical theorists would include in their models some elements of self-analysis, and whilst this sometimes denigrated as “subjective” and thus “not scientific”, mathematical (statistical) analysis of “normal behaviour” (based on human and animal experimentation) as the “only objective scientific method of study” has obvious limitations and dangers, many of which have become increasingly apparent in recent years.

The most influential medical doctor this century to present a model of human mental processes was probably Freud, a Jewish Austrian physician with rather suspect attitudes to women and children, who developed his theories through a combination of clinical experience (with asylum inmates and affluent private patients) and self-analysis. This was commented on by Professor Stanfield Sargent in the 1944 introductory textbook Great Psychologists (published by Barnes and Noble: New York), when the early division (and splintering) of European psychological theory into different (and often conflicting) schools of thought is described (with more than an element of idol-building and myth-making):

“In a young and growing science internal disputes often occur. Psychology is no exception. Psychologists have differed about what psychology should or should not include, about what it 57

should emphasize, about what research methods are best. When several psychologists strongly support a certain viewpoint they are called a “school”.

“Structuralism traces back to two men, WILHELM WUNDT and EDWARD BRADFORD TITCHENER. Wundt is regarded as the father of experimental psychology since he established in 1879 at Leipzig, Germany, the first psychological laboratory. To study with Wundt came young and eager psychologists from many countries. One of these was Titchener, an Englishman, who later came to America to head the psychology department at Cornell University for many years.

“Following Wundt’s basic ideas, Titchener established the school known as structuralism. Psychology is concerned with studying images, thoughts, and feelings, the three elements forming the structure of consciousness. The proper research method is introspection, performed by trained observers. Learning, intelligence, motivation, personality, or abnormal and social behavior Titchener ruled out of psychology [!]. He and his students did notable research studies…”

“Functionalism is a less systematic and unified school. It grew out of the protests of many psychologists against analyzing consciousness into ideas, images and feelings. The Danish psychologist HARALD HOFFDING, and the American WILLIAM JAMES both emphasised the dynamic, changing nature of mental activity and questioned whether it could be analyzed into structural elements. Shortly after 1900 JOHN DEWEY and JAMES ROWLAND ANGELL at the University of Chicago began to stress the ways in which an organism adjusts to environment. Their aim in studying mental functions was to discover how thinking, emotion, and other processes fulfilled the organism’s needs. The views of the functionalists helped to align psychology with biology and to bring about a genetic approach to psychological problems.” (p.5)

The author of the book, Professor S. Stansfeld Sargent (PhD) of Columbia University, fails to mention the word “eugenics” as the outcome of the “genetic approach to psychological problems”, although this 58

was common knowledge at the time, nor does he admit to the atrocities that were being perpetrated by “biological psychiatrists” in Nazi Germany over the years immediately preceding the writing of this book. Although Wilhelm Wundt is described as establishing “the first psychological laboratory”, the ethics of what was done in this “laboratory” and to whom, is not explored in this book, which idolises the “fathers of psychology” – listed in the preface as “Binet, Freud, Galton, Helmholtz, Hollingworth, James, Thorndike, Watson and Woodworth” followed by “Adler, Cannon, Cattell, Ebbinghaus, Gesell, Goddard, Janet, Jung, Koffka, Kohler, Kraepelin, Lashley, Lewin, Pavlov, Rorschach, Terman, Titchener, and Yerkes” who are said to be “associated primarily with more specialized work”.

Of these names a few have grown in fame (and notoriety) over the past fifty years, including Freud, Jung, Galton, Kraepelin, Rorschach and Pavlov. Freud and Kraepelin, especially, have many devoted disciples within the medical profession. Much of the animal research industry and ‘behavioural sciences’ research is based on Pavlov’s work on ‘classical’ conditioning of dogs (and humans). The Swiss psychiatrist Carl Jung is best remembered for his self-analytical work on dreams, symbolism and philosophy, although he was an active clinical psychiatrist (and physician). Michael Stone writes, in Healing the Mind (1998), of the relationship between Adler, Freud and Jung:

“Viennese-born Alfred Adler (1870-1937) was among the small group who met at Freud’s house in Vienna on Wednesday evenings to discuss important issues and developments in psychoanalysis. Adler believed that the crucial dynamic motivating human action was the wish for power. He articulated this notion in his 1907 book on Organ Inferiority (the source of his coinage: the inferiority complex).

“The first international meeting of analysts was organized by Jung in 1908. Freud read his paper on the “Rat Man”, a case of obsessional neurosis. At this time C.G.Jung was Freud’s “fair-haired boy”. Freud regarded him as brilliant and, of equal importance, hoped that this Christian physician, the son of a Swiss pastor, would help make psychoanalysis – thus far practiced almost entirely by Jewish professionals in Austro-Hungary – acceptable in the wider, gentile circles beyond the Viennese “inner circle”.” (p.141) 59

Jung himself, wrote of Freud, in Memories, Dreams, Reflections (1961):

“Psychiatry teachers were not interested in what the patient had to say, but rather in how to make a diagnosis or how to describe symptoms and to compile statistics. From the clinical point of view which then prevailed, the human personality of the patient, his individuality, did not matter at all. Rather, the doctor was confronted with Patient X, with a long list of cut and dried diagnoses and detailing of symptoms. Patients were labelled, rubber-stamped with a diagnosis, and, for the most part, that settled the matter. The psychology of the mental patient played no role whatsoever.

“At this point Freud became vitally important to me, especially because of his fundamental researches into the psychology of hysteria and of dreams. For me his ideas pointed the way to a closer investigation and understanding of individual cases. Freud introduced psychology into psychiatry, although he himself was a neurologist.” (p.135)

The scientific disciplines of “Neurology”, “Psychiatry” and “Psychology” can be best understood from the Greek roots of these composites of “neuro”, “psyche”, “logos” and “iatros”. “Neuro” refers to the brain and nerves, and the logic based scientific study of the nervous system has long been described as “neurology”. The idea of medical doctors trained in the treatment of the mind but not the brain is a relatively recent phenomenon, and has led to the absurd situation where a “mindless neurology” and a “brainless psychiatry” have become the only choices available for the medical graduate who wishes to undertake further study in the neurosciences. Psyche is variously translated as “mind” or “soul”, but it certainly does not mean “behaviour”, as some modern psychologists and psychiatrists suppose. Logos, translated literally means “word”, however in the context of “neurology” and “psychology” can be used to refer to the total scientific knowledge of the topic next to which the suffix is used. Thus neurology refers to collective human knowledge about the brain and nervous system, whilst psychology refers to collective human knowledge (including that of past times) about the mind, thinking and thought (and even to scientific study of soul, if the term is used unusually broadly). Psychiatry, combining psyche with iatros (treatment) refers to treatment of the mind (and soul) and it is difficult to see how the mind 60

can be rationally and scientifically treated by the medical profession without a rational scientific understanding of both psychology and neurology.

Following his introduction to Freud, Jung continues, in Memories, Dreams, Reflections with a description of his own psychoanalytical technique at work:

“I still recollect very well a case which greatly interested me at the time. A young woman had been admitted to the hospital suffering from “melancholia”. The examination was conducted with the usual care: anamnesis, tests, physical check-ups, and so on. The diagnosis was schizophrenia, or “dementia praecox”, in the phrase of those days. The prognosis: poor.

“This woman happened to be in my section. At first I did not dare question the diagnosis. I was still a young man then, a beginner, and would not have had the temerity to suggest another one. And yet the case struck me as strange. I had the feeling that it was not a matter of schizophrenia but of ordinary depression, and resolved to apply my own method. At the time I was much occupied with diagnostic association studies, so I undertook an association experiment with the patient. In addition, I discussed her dreams with her. In this way I succeeded in uncovering her past, which the anamnesis had not clarified. I obtained this information directly from the unconscious, and this information revealed a dark and tragic story.”

The story, briefly, is that the woman, who “was very pretty” was rejected by the “son of a wealthy industrialist” whom, according to Jung “she thought her chances of catching…were fairly good”. After marrying someone else, her depression had developed suddenly after being told that the wealthy industrialist’s son had “quite a shock” when she got married, followed by a tragedy when her young daughter died of typhoid fever, and she thought that the infection had been contracted by the child sucking on a sponge tainted by “impure” river water.

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In his description of the story and his “miraculous” cure of her mental illness by telling her she was a murderer, Jung seems to accept, and indeed reinforce, the assumption that the child developed typhoid by sucking on this sponge, even though the woman’s little son drank a glass of the river water without becoming ill:

“She was bathing her children, first her four-year-old girl and then her two-year-old son. She lived in a country where the water supply was not perfectly hygeinic; there was pure spring water for drinking, and tainted water from the river for bathing and washing. While she was bathing the little girl, she saw the child sucking at the sponge, but did not stop her. She even gave her little son a glass of the impure water to drink. Naturally, she did this unconsciously, or only half consciously, for her mind was already under the shadow of the incipient depression.

“A short time later, after the incubation period had passed, the girl came down with typhoid fever and died. The girl had been her favourite. The boy was not infected. At that moment the depression reached its acute stage, and the woman was sent to the institution.

“From the association test I had seen that she was a murderess, and I had learned many details of her secret. It was at once apparent that this was a sufficient reason for her depression. Essentially it was a psychogenic disturbance and not a case of schizophrenia.”

It is clear from Jung’s writings that, whilst recognising this woman’s distress as due to psychological traumas that she suffered in the past, he failed to realise that her predictable feelings of guilt that she had caused the death of her own daughter through “negligence” could have been treated in a much more humane way than by accusing her of being a murderer. He also accepted validity of the label of “schizophrenia” and an attendant poor prognosis, although he believed the pessimistic prognosis had been misapplied in this case. He also admits to being intimidated (and thus silenced) by the established hierarchy in the medical profession, such that he did not dare disagree with the diagnosis made by his ‘superiors’. In terms of ethical, biological and scientific logic, Jung appears to have failed to realise and evidently failed to explain to his patient that the belief she held that her daughter contracted typhoid by sucking on a sponge with river water in it was not a scientific certainty by any means, and the 62

accidental death of her daughter hardly made her a “murderess”, which by usual definition refers to the intentional killer of another person. The fact that she did not have schizophrenia would seem obvious, but a deeper exploration of why she had been diagnosed as such would have perhaps made more interesting reading than this rather self-indulgent account makes. Jung explains why he considered his “psychoanalytical psychotherapy” technique a success:

“I told her everything I had discovered through the association test. It can easily be imagined how difficult it was for me to do this. To accuse a person point-blank of murder is no small matter. And it was tragic for the patient to have to listen to it and accept it. But the result was that in two weeks it proved possible to discharge her, and she was never again institutionalised.” (p.137)

She may have committed suicide after being discharged.

Another ‘great psychologist’, according to Professor Sargent, the German psychiatry professor Emil Kraepelin, is still venerated as the father of biological psychiatry in Australia, and acclaimed for his work in formulating the basic classification of “mental abnormalities” and “deficiencies” that underpins modern medical psychiatric diagnosis and treatment. Continuing with Professor Sargent’s list of ‘great psychologists’, Rorschach is remembered for devising the ambiguous and unreliable “Rorschach test”, where inkblots are presented to the subject to be analysed and their responses interpreted by the analyst. Pavlov has become a household name (along with Freud) for conditioning (programming) dogs into salivating in response to a bell, but whose experimental legacy included cruel human experimentation also.

Professor Sargent continues his passage on “Schools in Psychology” with a description of “behaviorism”, yet another school of thought regarding thinking: 63

“Behaviorism was founded about 1914 by JOHN B. WATSON, then an animal psychologist at John Hopkins University. He too was impatient with the narrowness of structuralism, but he did not feel that the functionalists went far enough in their criticisms. Watson objected particularly to introspection, which he considered unscientific. Psychology’s real concern, he said, is to study behavior, not consciousness. Expose an animal or a human being to a stimulus and see how he responds; record this behavior objectively and you have real scientific evidence. Watson and his fellow behaviorists experimented on learning, motivation, emotion, and individual development.”

The school of ‘behaviourism’ has been very influential in Australia and the USA, to such an extent that many psychology texts define ‘psychology’ as the study of behaviour, rather than the study of thinking or the mind. According to Professor Sargent, “Psychoanalysis” is just another school of thought out of many competing models, and one that is scientifically suspect:

“Psychoanalysis stood apart from the other schools. Founded by a physician, SIGMUND FREUD, it grew out of his effort to cure persons suffering from mental and nervous disorders. Psychoanalysis presents amazingly fruitful and provocative theories of motivation, of personality development, and of abnormal behavior. Unlike other founders of schools, Freud made no effort to verify his theories by scientific experiment. Freud’s major interpretations and those of his dissident disciples are presented in the chapter called Conflicts and the Unconscious.” (S.Sargent in Great Psychologists, p6)

In Chapter 12, titled “mental disease”, Professor Sargent lists his preference for ‘psychiatric icons of all time’. Several names are listed in capital letters under the chapter heading: Hippocrates, Weyer, Pinel, Dix, Kraepelin, Bleuler, Griesinger, Beers, Campbell, White, Jackson, Meyer, Rosanoff and Lennox. The chapter begins with what, taken literally, could be a self-fulfilling threat: 64

“About one person of every twenty in the United States will at some time during his life be treated in a mental hospital. The care and cure of such persons is a tremendous problem.”

Then is presented a very misleading reference to the current humane versus the prior inhumane methods involved in the treatment of those deemed mentally ill or mad:

“Apparently mental disease has always existed, but only in the last fifty years has it been handled scientifically. We have progressed a long way from the days of cells and chains for the insane. We still have far to go to reach an ideal solution.”

The supposition that the mentally distressed, confused, upset or disturbed were routinely treated by all countries, nations, governments and families with “cells and chains” is obviously not correct. In fact it is a small minority of the population at any one time who have been treated in this way, and this sort of treatment has been ordered by only a few people (mainly men) who have had the authority to give such orders and have them implemented. Professor Sargent also fails to mention that the routine treatments given to psychiatric patients who had been diagnosed as suffering “mental disease” (or mental illness) were much more cruel and punitive than mere “cells and chains”. The imprisoned, chained “lunatics” (by many names) have been whipped, immersed in cold water or hot water, sensorily deprived, injected with known poisons and infections, made comatose, given electrical shocks to their head, genitals and hands, surgically or chemically castrated, had their teeth removed, starved and tortured in many other ways, always with the claim that these things were being done for the sake of the “afflicted” individual and the greater society. Inevitably a scientific sounding theory has been used to justify what would otherwise be clearly recognised as unethical and illegal abuse of the population by a “professional elite”.

Convincing the increasingly skeptical population of the world that they have a superior understanding of madness and sanity, mental illness and health to other “experts” and “non-experts” has been a longstanding concern of the psychiatric profession, and a “professional insecurity” can be seen in 65

efforts of “psychiatrists” and “psychologists” to claim a position as “legitimate scientists”. The problem of scientific credibility is addressed by Professor Sargent in the following way:

“We have called psychology a science. Is this correct? Astronomy, chemistry, and physics are readily recognized as sciences; they involve careful laboratory work, exact measurement, rigid laws, and sure-fire predictability. Psychology is concerned with something less definite and tangible; exactitude is hard to obtain and exceptionless laws almost never occur.

“However, it is not the definiteness of its material which determines whether a subject is a science. (If it were, biology might be excluded since it studies the great unknown - life.) KARL PEARSON, an English mathematician and scientist, insisted nearly fifty years ago that the criterion of science is not subject matter but the methods of investigation used. If scientific method is used systematically, we may properly speak of a science, whether the object of study is minerals, bacteria, human thoughts and feelings, or social institutions.

“Scientific method is no mystery. It is a definite procedure used in trying to answer a question or solve a problem. The problem may be a practical one like “What causes malaria?”, “What causes mental disease?”, “How does alcohol affect behavior?” Or the problem may be inspired by mere curiosity: “Why do objects fall to the earth?”, “How does heredity work?”, “Can animals learn?”

It is interesting that Professor Sargent should mention these particular “problems” and “questions” and it is worth looking at the ways in which these scientific, biological and social phenomena have been researched in the years since this book was written, and what conclusions have been reached by “the scientific community” about them. It is also worth looking at the medical research that was occurring in institutions associated with Columbia University where S. Stanfield Sargent was employed as “Associate Professor of Psychology” during the Second World War.

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The first question, “What causes malaria?” can be answered easily on the most obvious level: infection with Plasmodium malaria parasites, which are carried by mosquitoes, and transmitted into the blood through the skin by mosquito bites, usually from Anopheles or Culex mosquitoes. This is, however, only a partial explanation of what causes malaria. Firstly, not everyone who has malaria parasites injected into their skin will develop malaria (depending on immune system health), and secondly, not everyone who has contracted malaria has done so by being bitten by mosquitoes. Some have been given infections by deliberate transfusion of infected blood to test new antimalarial drugs. And at doses that made serious illness certain.

It is a little-known fact that during the Second World War and for a few months after it ended, disabled Australian soldiers, along with Jewish refugees and interned Italians were subjected to secret experiments in remote North Queensland where they were transfused with bags of blood that were laced with malaria and subjected to bites from mosquitoes specially bred to carry huge loads of the malarial parasite. The objective was to find ways to counter the mortality and morbidity of Allied troops in the tropics, The infected blood was provided by the Red Cross; the mosquitoes capable of carrying hundreds of times the normal load of malaria were bred by the Council for Scientific and Industrial Research (CSIR), the forerunner to the CSIRO. These “human guinea-pig” experiments were first reported fifty years after they occurred, in the Fairfax press (publishers of The Age, which carried the reports). True to form, the Murdoch press (which owns most of the other newspapers in Australia) did not mention these experiments.

As for the vexing question of what causes mental disease, it depends on how mental disease is defined. Is war-mongering is an indication of mental disease? Is the manufacture of landmines and multibarrelled heavy weapons indicative of madness? Is demonizing dissidents a sign of mental illness? By this token, can nations, as well as individuals. be mentally ill?

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PRIVATE HOSPITALS AND MILITARY CONNECTIONS

In the 1940s, at the same time that Professor Sargent wrote Great Psychologists, and the nations of Europe were engaged in a bloody struggle for territory and supremacy, an undisclosed number of men and women were deliberately infected with malaria in Australia – by the Commonwealth army in conjunction with the British and Australian (Commonwealth) governments, and American and British pharmaceutical (drug) companies. The drug trials, on interred Italians and Jewish refugees, as well as wounded Australian soldiers (who were obtained from convalescent hospitals), were reported in the Australian newspapers over 50 years after they occurred, and were hardly commented on by the scientific press or politicians in the country in which these terrible abuses occurred. The experiments, on people described in the Age articles as “human guinea pigs”, were done in North Queensland (and later, in Melbourne) during the Second World War and for several months after the official cessation of hostilities, driven by the military and financial motive of testing new antimalarial drugs developed in Germany for toxicity by “the Allies” on captive populations. It is difficult not to see this as a hostile act against Australia and the Australian people, as well as the Italian and Jewish people who were subjected to torture, which was then denied.

Even with the revelation of details of these cruel and unnecessary acts by the Australian and British Governments of the day (who ultimately hold responsibility for their armed forces), the deliberate infection and poisoning of these people was not described as torture or biological warfare by the Age newspaper, although the reporters did describe the incident as “abuse”. The Murdoch-owned newspapers in Victoria (The Australian and The Herald Sun) did not take the issue up, and The Age did not persist with the “historical story” or make the necessary connections with contemporary medical science and research activity in Australia (and Melbourne, in particular) to understand why Guy Nolch may have written in the editorial of Australasian Science that “little has changed in 50 years” when commenting on biological warfare suggesting that the fault lies not with “the scientists” but “the masters who control them”. 68

The drug Paludrine was being tested for ICI chemicals, a large British-based company which continues to market the drug today, and the director of ICI Australia, Ben Lochtenberg, had been, for several years, the director of the Mental Health Institute in Parkville, Melbourne, when the reports of the malaria tests were finally made public in The Age. “ICI”, which is an acronym for “Imperial Chemical Industries” was founded in 1926, during a period of time between the two “World Wars” that has been referred to as “The Depression”. Around the same time as the revelations about the infection and treatment “trials”, ICI pharmaceuticals was transformed into Zeneca pharmaceuticals, which in 1999 became amalgamated with the Sweden-based Astra pharmaceuticals, forming a new giant drug company called “Astra-Zeneca”. The huge non-pharmaceutical operations of ICI continued as ICI chemicals, unaffected by the merger, according to the Information Service provided on a 1800 number by Astra-Zeneca. The phone message of the old Astra-Zeneca number in Melbourne announced, when I called the number on 1.9.99, that the Melbourne office of Astra-Zeneca has closed, and the head office relocated to Sydney.

The malaria infections, which occurred in remote North Queensland, under the auspices of the Red Cross, Royal Australian and British Military, involved deliberately exposing physically and psychologically stressed individuals to extraordinarily high doses of malaria through specially bred mosquitoes and transfusions of blood infected with malaria. The infected people were then subject to physical trauma such as exposure to cold and then given massive doses of the chemicals to be tested, observing for toxic effects. After the war ended, according to the newspaper reports, pressure from the American drug company Winthrop (producers of Panadol) and ICI resulted in the trials being shifted to the Heidelberg Military Hospital in Melbourne, which had orchestrated the Australian trials. Panadol and Panadeine (paracetamol with codeine), previously Winthrop brands, are now marketed in Australia by the Consumer branch of SmithKline Beecham.

Heidelberg Military Hospital, which was built in 1941, became the Heidelberg Repatriation Hospital in 1947, and became incorporated with the adjacent Austin Hospital in 1995 to form the massive Austin and Repatriation Hospital located in the North-Eastern Melbourne suburb of Heidelberg. The Austin 69

hospital, now the biggest hospital in Melbourne according to the Public Relations Department of the hospital, was one of Melbourne’s first hospitals, and was built in 1882. It is, like Melbourne’s first hospital, the Royal Melbourne Hospital in Parkville, which was built in 1848, affiliated with the University of Melbourne, which was founded in the 1860s, at the time of the gold-rush. Both these hospitals are major teaching hospitals (for medical students) and public hospitals which treat Melbourne people who cannot afford, or do not want private medical care. They also both provide public psychiatric services, including locked facilities for people to be injected in against their wills. In February, 2000, the public relations officer at the Royal Melbourne Hospital explained to me that the hospital has recently opened a unit with 25 “acute beds” and 8 for people (usually girls) with “eating disorders” (mainly anorexia). Previously, the Royal Melbourne Hospital was associated with the notorious Royal Park Psychiatric Hospital, which has recently been closed and partially demolished to make room for a visiting athletes at the Commonwealth Games. The unsuspecting athletes will be housed on a site where thousands of young Australians have been imprisoned and tortured over the years – with electric shocks and huge doses of chemical toxins. Many have died, either during their ‘treatment’ or shortly after it. Their deaths have inevitably been reported as ‘suicide’.

On 1.9.99, the Age newspaper in Melbourne announced in an article headlined titled “Coalition pledges $1b for health” that, “the coalition’s announcement came as the Opposition launched its health strategy, promising to spend an extra $270 million building and upgrading hospitals – including $155 million to ensure the Austin and Repatriation Medical Centre remained in public hands.” The Austin and Repatriation Medical Centre has never really been in public hands. “Public hospitals” in Australia are, like the medical profession generally, controlled by elites – who tend to support the pharmaceutical industry as well as the military industry. The Heidelberg Military hospital, which became the “Heidelberg Repatriation Hospital”, was initially a British-Australian Military Hospital, which coordinated medical military activity during the Second World War (in the 1940s). This is the hospital that coordinated the malaria experiments on interned Italian and Jewish refugees during the WWII, and treated “veterans” for shell-shock (later termed “post-traumatic stress disorder”) after this war and all the wars Australia has been involved in since then. These include the wars in Korea, Vietnam, New Guinea, and Malaya. 70

The 1943 University of Queensland publication The Nervous Soldier by Professor John Bostock (of the University of Queensland and Brisbane General Hospital) and Dr Evan Jones (of the University of Sydney) gives an indication of treatment methods employed in Australia during the Second World War, as well as the favoured diagnoses of the time. The book recommends “traits which will suggest need for psychological investigations” in soldiers, because, according to the manual, “the military machine must have efficiency at all times”. These “traits” include: “resentfulness to discipline or inability to be disciplined”, “unusual stupidity or awkwardness in drills or exercises”, “inability to transmit orders correctly”, “personal uncleanliness”, “criminal tendencies”, “abnormal sex practices and tendencies including masturbation”, “filthy language and defacement of property”, “distinct feminine types”, “bed wetters”, “subjects of continual ridicule or teasing”, “queer or peculiar behaviour”, “chronic homesickness” and “all recruits who show persistent fearfulness, irritability, seclusiveness, sulkiness, depression, shyness, timidity, anti-social attitude, over boisterousness, suspicion, dullness, sleeplessness [or] sleep walking”. (p.80)

The authors “rule out” those with “mental deficiency, epilepsy, schizophrenia or manic depression” from employment in the armed forces, and gives the following description of ‘schizophrenia’:

“Whilst the fully developed schizophrenic personality is so obvious that it cannot escape recognition, milder forms may be recognised by certain character traits. They are sensitive, reserved, bad mixers, unpractical, abstracted and dreamy, and generally have difficulty in facing ordinary problems. Their mind is made up with difficulty. They may lack the power of concentration. These traits make them unsuitable material for soldiers. It is noteworthy that during the last war 20 per cent of mental invalids belonged to this class.”

Not surprisingly, the main problems diagnosed in soldiers were related to anxiety (ranging from ‘normal nervousness’ to ‘grave anxiety states’). The recommended treatments for more severe states of anxiety were “convulsion” (chemical shock) therapy and “narcotherapy”. Milder cases were treated by suggestion, hypnosis, ‘hypno-analysis’ and ‘narco-analysis’. Electrical shocks are also briefly 71

discussed (as ‘Faradism’), and insulin coma, whilst considered an effective treatment by the authors, was not considered appropriate for military use. Alcohol was also used as an ‘anxiolytic’ and such use was recommended as follows:

“The role of alcohol for the soldier cannot be lightly dismissed. Drinking is a method of evading reality. Those who deprecate the use of alcohol should imagine themselves attacking a machine gun at dawn with death or mutilation a probability. In such cases some evasion of reality is perfectly justifiable. The report by the War Office on shell shock states that whilst alcohol must be rationed “front-line medical and executive officers favoured the use of rum if properly controlled: it was especially valuable in the early morning hours.”

“Service conditions create periods of abstinence, boredom and danger. At their conclusion there is an irresistible urge for conviviality, which exposes the soldier to alcohol at a time when his tolerance is low. It is not surprising that cases of acute alcoholism are inevitable. Whilst such lapses are to be deprecated from the angle of discipline, the Medical Officer is concerned purely as a doctor whose job is to make a presumably good soldier fit to resume his duty.” (p.69)

In The Nervous Soldier, alcohol and cigarette abuse are identified as being caused by military training, although it is not admitted as clearly as that. Under the subtitle, “the preliminary military training”, in a chapter titled “The Stresses of Military Life”, Bostock and Jones wrote, in 1943:

“When Bill Smith receives his first uniform he must face an entire alteration in his living conditions. His contacts are different. He is shorn of many personality props and of the friends and relatives of a life time. They are replaced by new faces and strange voices. Soon he learns that he is fettered and frustrated by disciplinary restrictions. His soul belongs to the army. For both married and unmarried there is a modification of the sex routine. For some the change is towards continence; others are snared in the net of promiscuity with its attendant worries. The conditions of military life are calculated to stir into activity repressed homo-sexual tendencies resulting in the development of anxiety states or of paraphrenic psychoses. Even the alcohol 72

and tobacco habits partake of the change. There is a move from teetotalism towards drinking, often to excess. Tobacco becomes almost a necessity.” (p.15)

The authors do not seem to realise how permanently destructive the training of young men in this way is bound to be for society generally, whilst admitting that it destroys fundamental respect for life:

“…and in addition there is another aspect manifesting itself. The aggressive instincts are unfolding. The soldier trained from infancy to regard human life as sacred must become efficient in taking life when necessary. Unless he can learn to kill his enemies, military training is futile.” (p.16)

The prime motivator for a successful soldier, according to The Nervous Soldier is patriotism. Ironically, the opening chapter suggests that fighting (and killing) in support of the British “war effort” (despite the British imperial history of slavery and oppression), is actually a fight for freedom from Nazi slavery and Japanese imperialism:

“We are actors today in one of the great moments of history. We are called to help free a large proportion of civilization from the enslaving serfdom of German Nazism and Japanese imperialism. We realise, as never before, the value of personal and national liberty. This liberty, which has been brutally snatched from the Czechs, Danes, Norwegians, Poles, Dutch and Greeks, has assumed a new significance for us in the face of danger. Hitherto we took it overmuch for granted. Democracy alone provides the way of life and the form of government under which it can live and flourish. So Democracy must prevail or freedom will vanish from the earth. This is an incentive, this is a motive that should have the power to light the torch of unflagging enthusiasm in us. And today we of the Anzac zone have another motive – perhaps the most primitive of all – that of defending our homes from destruction and our women and children from slaughter.” 73

The fact that democracy is incompatible with monarchies and authoritarian hierarchies evidently escaped the psychology professors who wrote this manual, and the treatments they gave to “nervous soldiers” were not based on the democratic will of the Australian people. They were based on the psychiatric dogmas prevalent in British and Australian universities and hospitals at the time, and an agenda based on producing efficient killing machines who obeyed orders unquestioningly, accepted punishment without complaint (discipline) and were willing to sacrifice their lives for the elites who gave both the orders and the punishments (whilst believing they were fighting and risking injury or death for ‘freedom and democracy’).

The mainstay of treatment for severe anxiety was, incongruously, chemical shock therapy, involving the intravenous injection of drugs which caused convulsions. These drugs included cardiazol and phrenazol, which also caused acute terror and death, at times:

“Shock therapy has received such widespread recognition during the last few years that there is little need to describe the method in detail. As it is particularly useful in the early stages its employment in anxiety and hysterical conditions associated with war will often be indicated. The treatment should be carried out by a trained team, and under such conditions that complications such as fractures, should they occur, can be adequately dealt with. This will include access to an X-ray unit. It is obvious therefore, that the method is not applicable under field conditions.”

The book continues to give details of dose, and injection technique for inducing convulsions using cardiazol, warning that, “if a convulsion fails to occur the results are often most unpleasant, if not harmful”. The trauma of such treatment is easy to imagine:

“The patient is in a dorso-recumbent position with a pillow under the head and another under the upper thoracic region. During convulsions the upper extremities should be held adducted to the trunk and the shoulders are pressed down to avoid violent flexion of the dorsal spine. Hold 74

patient rigidly by shoulders to the bed, see that the limbs are straight. A fracture of any limb may occur, but is less likely if these precautions are carried out”. (p.58)

“Narco Therapy”, essentially the same as the notorious “deep sleep therapy”, was reserved for resistant cases. With an inexcusable ignorance about the difference between a “good night’s sleep” and a drugged coma, the authors gave a revealing ‘case history’:

“There is a growing belief in the utility of narco therapy for early cases. Everyone is aware of the benefits of a good night’s sleep particularly after a heavy and worrying day. Public belief in the efficacy of sleep is profound. “Oh, doctor,” says the patient, “if I could sleep for days, I would be cured.” Today we are able to achieve this miracle often with remarkable results. As an instance the following case may be quoted.

“AB was profoundly depressed and said he had venereal disease. Suggestion and persuasion with exhaustive blood tests were useless. Shock therapy was then tried without success. Finally he was put to sleep for three weeks. When he awoke to reality the previous morbid ideas had disappeared. Within a few days he was anxious to return to work. [He may have just stopped complaining about his fear, for obvious reasons]

“As will be seen by the above, certain cases which do not respond to cardiazol may respond to narco-therapy. Quite frequently sleepnessness and restlessness or excitement render it either impolitic or impossible to give shock therapy. Whenever this occurs, there is scope for the use of narco-therapy.”

As for “physio-therapy” the psychiatrists who wrote The Nervous Soldier were not talking about aerobic exercise. The section on “Physio-Therapy” begins with an extraordinary description of the value of electrical shocks: 75

“Electricity plays a small but definite part in the treatment of nervous disorders. Faradism may be used with dramatic results. The inert muscle at its touch leaps into spasm associated with discomfort if not pain. Faradism has therefore a distinctly persuasive quality since it gives ocular proof that paralysis is not complete. Furthermore as a method of treatment, it has the merit of being uncomfortable and therefore carries with it the suggestion, “Get well quickly and be finished”.

“In hysteria faradism will be used most frequently for mutism and paralysis. In the former the electrodes may touch the naso pharynx [the back of the throat] or be applied to the neck.” (p.61)

In actuality, the “suggestion” is: “get back to the firing line or we’ll torture you with painful electric shocks and chemically-induced convulsions”. The focus on “efficiency” means that doctors are expected to return soldiers to “active duty” as soon as possible and while spending minimal time with them (hence the enthusiasm for “quick treatments” like electrical and chemical shocks). In a section titled “enlisting the help of a cobber” the book explains:

“A medical officer can only be with any one patient for a few moments. He needs therefore an extension of himself to carry on the good work…Often a word with a man’s cobber will infuse new hope and if he has no cobber, see his platoon officer, and find him one.”

A few years before George Orwell wrote Nineteen Eighty-Four, Bostock and Jones wrote:

“Most men are better for a big brother. When needed the Medical Officer must take practical steps to find him.” (p.71)

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Wars make a lot of money for some industries, notably the weapons-manufacturing industry, mining industry, chemical industry, espionage industry, drug industry and medical treatment industry (including the psychiatric diagnosis and treatment industry). In recent wars, the increasingly influential “humanitarian aid” industry has also become a noticeable profiteer. All these industries are now set up along “corporate” lines, and “compete” with each other for credibility, sales and size. Many of the “humanitarian aid” and “charity organizations” have completely betrayed the noble ideals expressed in their titles and do the very opposite of what they are claimed by their “public relations departments” to do.

Although on paper these may be “non-profit organizations”, it should be remembered that in Australia and America “non-profit organizations” including “religions” and “charities” do not have to pay tax. Australia has therefore become a tax haven for corrupt religious organizations and charities, the money raised from the public being spent on projects which are dubious, to say the least. Many of these “charities” ostensibly raise funds for “medical research” which turns out to be largely spent on promotion of disease and treatment services, drug trials and human (and animal) experimentation, often orchestrated by universities and “independent” research institutions located in and connected with public hospitals.

In Australia, as well as in Britain and America, the training people receive in universities regarding philosophy (including ethics), economics, marketing, politics, sociology, medicine and psychology are not directed towards ideals of truth, honesty, justice, kindness, generosity and peacefulness. The reasons for this can be elucidated historically, politically, and economically. They can also be looked at psychologically and scientifically. However they are approached, they should be looked at logically if we are to recover from the militarisation and corporate takeover of Australian education. With the corporatisation of the tertiary education system in Australia, the focus has been on training young people to get a job, beat other people (compete ruthlessly), make more money and be “compliant consumers”. The tertiary education institutions in Australia also teach, and have developed within a “support-of-the-military paradigm”, especially in the areas of science and medicine. 77

This corporate takeover of medical education has been accompanied by changes in medical and psychiatric terminology. The change of status of psychiatric victims from “prisoners” to “lunatics” to “patients” to “consumers” and “clients” has been an official one overseen by senior members of the psychiatric profession in Australia, along with other changes of name, such as “mental hygeine” to “mental health”, and “human-rights” to “anti-psychiatry”. Others, such as “eugenics” and “biological warfare” have disappeared from the vocabulary of doctors in Australia, to be replaced by “psychiatric genetics”(when applied to local practices) or “ethnic cleansing” (when applied to the Allies’ military opponents).

The elaborate system of psychological “training” that soldiers are programmed with to “stop thinking about it” and “keep fighting without questioning orders”, has profound effects on their behaviour during “action” (fighting and supporting “the war effort”), as well as afterwards, when they find it impossible de-program themselves and “return to civilian life”. This is where the “repatriation” and “veterans” hospitals have developed and extraordinary system of “blame the victim” psychiatry. The “veterans” were said to suffer from “mental illness” or “nervous disorders” and discharged from the armed forces, sometimes on a pension from the “Commonwealth Department of Veterans Affairs”. Alcoholism, aggression, violence, drug addiction, gambling, nightmares, depression and chronic anxiety are all common problems amongst “returned soldiers” and are the real fruits of war.

Such men have been both honoured and ignored. The ‘well-behaved’ soldiers, who accepted their injuries and dwindling government services quietly were publicly lauded, once a year, at “Anzac day marches”, ‘lest we forget’, while those who were angry, upset, confused or horrified by their war-time experiences were impolitely ‘pensioned off’ with whatever ‘nervous disorder’ diagnoses were in use at the time. These included ‘shell-shock’ after the First World War and ‘post-traumatic stress disorder’ after the Vietnam War.

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The old Heidelberg Military Hospital, which treated thousands of returned soldiers (and experimented on others, according to the Age report on “human guinea-pigs”) is now part of the Austin and Repatriation Medical Centre in Heidelberg, and proposals have been made, in recent years, to ‘privatise’ the hospital (sell the hospital to individuals and corporations), as has been done with several ex-military hospitals around Australia in recent years.

One such hospital is the Repatriation Hospital at Greenslopes in Brisbane, which was sold to Ramsay Health Care, who claim, in their glossy 1997 prospectus that:

“Ramsay Health Care was established in 1964 and has grown to become one of the largest and most successful private hospital operators in Australia. The origins of Ramsay Health Care were in the field of psychiatric healthcare where it achieved a reputation for innovation in many areas of psychiatry and for providing high quality care. The same culture and principles apply in all its healthcare operations, which now encompass a diverse range of medical/surgical hospitals in addition to psychiatric hospitals.”

The prospectus also announces that the company, which “owns and operates 11 hospitals located in New South Wales, Victoria, Queensland, South Australia and Western Australia, with a total of 1,351 beds” had signed contracts in May 1996 with TF Woolham & Son Pty Ltd “to construct a new 30 bed psychiatric ward at Greenslopes Private Hospital for the sum of $1,515,011” and Transfield Constructions Pty Ltd (for $11,035,597) to build four more hospital wards at the “Hollywood campus” in Western Australia. In May, 1996, the prospectus reports, Kilcullen & Clark was engaged to design and construct a psychiatric unit on the Hollywood campus for the sum of $2,489,749.

In Victoria, the main centre of Paul Ramsay’s huge private psychiatric empire is the “Albert Road Clinic” in Inner Melbourne. The prospectus explains: 79

“Albert Road Clinic was opened in July 1995 and in part was a conglomeration of three existing psychiatric hospitals owned by Ramsay Health Care. These hospitals were closed upon the opening of Albert Road clinic. Albert Road Clinic is an 80 licensed bed facility which is recognised throughout Melbourne as a major specialist referral centre. The clinic specialises in the treatment of eating disorders, adolescent disorders and elderly assessment and through its mood disorders programme, has formal links with the University of Melbourne.”

Simultaneously, in a contract that has been kept secret by the Victorian State Government, a “135 bed forensic psychiatry hospital” has been constructed at Yarra Bend, adjacent to the Fairfield Hospital and current home of the Macfarlane Burnet Virology Institute, which is to be relocated adjacent to the Alfred Hospital in Prahran (in inner eastern Melbourne). The Macfarlane Burnet Centre, which advises the National and State Governements on HIV, AIDS and AIDS prevention, is run by their Chief Executive Officer and Executive Director the American Professor John Mills, who heads the “Children’s Virology Department”, according to their 1998 Annual Report, as well as being CEO of the company. Possibly presenting a major conflict of interest, Professor Mills is also described as the Director of AMRAD pharmaceuticals, which has recently constructed a massive new complex also in prime land by the Yarra River.

AMRAD corporation, Macfarlane Burnet Centre, the Alfred Hospital and Forensic Psychiatry Hospital, as well as the Austin Repatriation Hospital all have formal and informal links with the University of Melbourne, Melbourne’s oldest university, and one of only two in the State of Victoria authorised to produce medical graduates and train them in various areas, the other being Monash University, founded in the 1960s. This includes the training of medical specialists including psychiatrists and specialists on public health, including international public health. This training is a prolonged process involving in six years of undergraduate study, a years internship in the public hospital system, and a variable number of years in the public (“teaching”) hospital system during which they are examined by senior specialists and, if they satisfy various criteria, allowed to call themselves specialists also (and claim both authority and increased fees). The same system, with some variations, is in operation throughout 80

the world, including Britain, where it originated, the USA, Canada, New Zealand, Europe, Africa, Asia and Australia.

Predictably, given the history of Australia, the medical and scientific institutions in Australia maintain close philosophical and political links with the old English Universities Oxford and Cambridge in addition to an increasing influence from Harvard, Yale and other universities in the USA. It is usual practice, and often considered obligatory, that as part of their “higher education”, medical graduates spend at least one year in Britain or the USA before receiving their specialist qualification. It is also the case that many doctors with medical qualifications obtained in the United Kingdom and New Zealand are practising in Australia, without any particular qualification in the unique health problems and psychology of the Australian people or a knowledge of their history or culture. Extraordinarily, many of these doctors, some of whom also qualified in other Commonwealth countries, such as New Zealand, Sri Lanka, India and Canada, are working in the area of clinical and academic psychiatry, where a sensitive approach and detailed knowledge of the diverse cultures and languages of Australia is surely essential.

There are several political reasons why the psychiatric system in Australia is disproportionately populated by doctors who are not Australian – by birth, or culturally. Many are not Australian citizens and do not regard Australia as home. This is important because when treating people’s minds, one’s loyalties, including national loyalties (and concepts of ‘patriotism’) are important – especially when making diagnoses of political beliefs. Revolutionary thought and action is proscribed by psychiatric diagnostic criteria, including revolutionary thought in the areas of politics, philosophy, religion and science. Challenges to the authority of the state and the ‘system’ (wherever it is located) are also proscibed by psychiatric criteria for the diagnosis of delusions, psychosis, schizophrenia and mania. Thus those who attempt to radically change the existing system or demonstrate hostility or aggression towards it can be diagnosed, though a complex web of jargon and concepts (such as ‘paranoia’, ‘thought disorder’, ‘affective disorder’) as “incurably mad”. This system of diagnosis can be, and has 81

been, abused in every part of the world in which it has been implemented, not least of all because it is obviously politically expedient to discredit opponents as “mentally ill”.

It is so obvious that this system can be abused that most States which employ psychiatric diagnoses also have laws proscribing the misapplication of labels of madness for political, religious and philosophical beliefs. This is the case in every State in Australia – however gross abuses in the application of these labels occurs, and many people have been crippled and died, while they could have been (and may have been) great artists, philosophers, poets, or politicians. The reason so many potentially wonderful careers are destroyed by psychiatric diagnosis and treatment is that the criteria defining ‘abnormality’ enshrined in psychiatric texts are fundamentally anti-creative. Dopamine- blockers inhibit creative thought, and the diagnosis of original (idiosyncratic) ideas as “psychotic” (out of touch with ‘reality’ as defined by the medical profession) also inhibits creative thinking. This includes so-called ‘lateral thinking’ (referred to as ‘flight of ideas’, a ‘classical symptom’ of ‘mania’ and ‘hypomania’) and belief in things that others do not believe (‘delusions’).

The label of ‘mania’ can also be applied to people who become progessively more outspoken, adventurous, spontaneous or generous. Giving away expensive presents and giving away one’s possessions are regarded as typical ‘manic activities’, as is, incredibly, striking up conversations with strangers on a train, and “increase in goal-directed activities” (DSM IV, 1995). While states of insane mania may exist, the criteria for diagnosis of hypomania and mania are biased against particular types of activity and particular beliefs. These are proscribed, not because they are unhealthy, but because of the political and religious background within which psychiatric diagnostic criteria were developed. In terms of politics, ‘acceptable’ views, according to the ‘apolitical criteria’ of the DSM and ICD classifications are essentially capitalist, obedient of the laws of land (whether good or bad laws) and compliant with medical directives and orders.

Of course, the psychiatric profession in Australia, New Zealand, Europe and North America do not admit to having been affected by Cold War paranoia (or propaganda) or to retain biases from the eras 82

of colonialism, imperialism and Christian crusades (and inquisitions). The struggle for emancipation and human rights is not mentioned in psychiatric texts, and the history of psychiatric atrocities is selectively omitted when the story of medical advances is told in the many popular medical history books which tell of the miracles of penicillin, immunization, micro-surgery and modern genetics. This is the version of ‘medical history’ taught in medical schools around the world, including the University of Queensland, where I myself learned the “Official History of Western Medicine”. Actually there was hardly any history included in the medical curriculum, true or false – we learned names of important scientists but not where and when they lived (or what their assumptions and biases were – essential knowledge if one hopes to reasonably evaluate their theories and conclusions). Inevitably, every medical student that graduated as a doctor (including myself) believed the core tenets of the Official History of Western Medicine by the time we had finished our 6 years at university. We had been carefully and methodically programmed to accept our place in the system that trained us, and to accept that any fundamental changes to this system would occur “very slowly” and that anyone who thought otherwise was “unrealistic” – out of touch with reality.

For ‘foreign graduates’ to be registered as medical doctors in Australia, they must fulfil conditions stipulated by the Commonwealth Government-sponsored ‘Overseas Doctors Training Program’, which makes it far easier for some doctors to work in Australia than others. This depends, largely, on where they trained – graduates from British, Canadian and New Zealand universities find it much easier to gain registration to work as doctors in Australia than those who trained in the “third world”, China or Russia. This is said to be related to the doctors’ proficiency in English, the argument being that doctors who cannot communicate adequately in the English language should not be allowed to work as doctors in ‘English-speaking’ Australia. The same argument, however, makes it doubly inappropriate that doctors who do not speak and fluent English should be employed in the area of public hospital psychiatry – where ability to communicate with patients and understand their culture and language is all-important.

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The reason usually given for foreign graduates working, at least temporarily, as psychiatric registrars and residents, when they first come to Australia, is that there is a shortage of local graduates to work in the public hospital psychiatric system. This may be true, but if so, there are good reasons why local graduates do not want to work in the capacities demanded of them by the psychiatric system – signing orders that take away their neighbour’s rights and freedoms, and prescribing that drugs and injections be given to people against their will. Most in Australia do not regard such activities as fgiving people a “fair go”, but most do not know what goes on inside psychiatric hospitals. Many have noticed, however, that people often come out worse (after treatment) than when they went in.

There is large-scale public cynicism regarding the medical profession and suspicion regarding the cosy relationship between doctors and the pharmaceutical industry. I have heard accusations that doctors often have shares in drug companies, which I do not believe to be the case. Most doctors overprescribe drugs not because of pecuniary interest, but because they are trained to do so. They are trained to diagnose illness, order investigations, refer to specialist colleagues and prescribe drugs. This is an important part of medical training, which is necessary for the good scientific use of medications, however, without a holistic approach and a knowledge of non-drug approaches, the medical profession is seriously blinkered – seeing people as labels and statistics which can be only treated with chemicals and scalpels.

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BEHAVIOUR CONTROL AND SOCIAL CONTROL

The United Nations Universal Declaration of Human Rights (1948) states that “no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment” (article 5). The same collection of International Laws states that “everyone has the right to freedom of thought, conscience and religion” (article 18) and that “everyone has the right to freedom of opinion and expression”

(article 19). These rights are fundamental to any democratic society, however much they are ignored or perversely misapplied.

The Australian population is ostensibly protected from the perverse misapplication and misinterpretation of laws by a legal concept termed “natural law” or “natural justice”.

Natural law is rarely quoted in Australian courtrooms, but it is said to be an important principle in the hearings of the Mental Health Review Board in Victoria and equivalent bodies in other states. These are semi-formal hearings with the power to authorise the release or continued incarceration of people held against their will by the public hospital system, when the usually drugged patient is interrogated by a lawyer and psychiatrist, with a largely symbolic “community visitor” present to provide a semblance of impartiality. The proceedings are unrecorded other than the notes of the lawyer for the Board.

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The Annual Report of the Victorian Mental Health Review Board and Psychosurgery Review Board for the year ending 30 June 1998 states that the Board heard 4827 cases in 1997-98, an increase of 11.6% from the previous year, when 4326 cases were determined. In 1990-91, 2657 cases were heard, and a constant rise in the number of cases has occurred each year since then. Of these 4827 cases 33% were involuntarily detained inpatients (held against their will in hospitals) and 63.4% were people objecting to community treatment orders (CTOs) which had been made against them by psychiatrists. Of these appeals, only 5.7% of patients were discharged.

An argument that could be put forward to justify this low release figure is that few of the people denied their freedom were not in need of forced treatment and denial of the right of free movements that other citizens are entitled to and take for granted. In other words, most of the people incarcerated and forcibly injected with major tranquillisers (‘antipsychotics’) need this treatment for their own wellbeing and that of society, and thus no human rights abuses are occurring through the actions of the Mental Health Review Board.

Examination of the criteria by which mental illness is judged, the personal experience of the author, the Report of the Seeking Justice Project and several cases cited in the Annual Report of the Mental Health Review Board (1998) show that, in fact, systematic abuses of young peoples’ right to freedom of thought, speech and action are occurring as a direct result of inappropriate determinations by the Mental Health Review Board, which largely supports the treatments meted out to psychiatric patients in Victoria, regardless of how cruel these treatments are, often based solely on “lack of insight” in patients regarding their “mental illness” and the “need for treatment”(drug treatment).

The Board routinely turns a blind eye to irregularities in paperwork and medical records, excessive doses of drugs forced into patients, assault by nursing staff, long periods of solitary confinement and punitive or coerced electroshock treatment, all of which are occurring in Australian hospitals today, 86

and which regulatory bodies such as the Mental Health Review Board have a legal and ethical responsibility to identify and prevent.

According to the report, in 1998, only 3 of the 24 psychiatrists on the Mental Health Review Board are women, but 10 of the 23 ‘legal members’ and 14 of 19 ‘community members’ were women. All five professors (the highest rank in the academic hierarchy) were men. These included three professors of psychiatry, Professor Richard Ball, Professor Graeme Mellsop and Associate Professor Sidney Bloch. Professor Bloch co-edited Foundations of Clinical Psychiatry, the standard textbook for medical students at Monash University and the University of Melbourne (at which he is one of several psychiatry professors). He also gave the 1996 Beattie Smith Lecture at the University of Melbourne, a ‘revised’ version of which was published in 1997 in the Australian and New Zealand Journal of Psychiatry.

In it he ironically warned:

“Those who do not learn from history are doomed to repeat it, claimed Santayana. What can we learn from the Soviet and Nazi horrors? We can recognise in both contributory elements derived from concepts moulded by the psychiatric profession itself. In the USSR the monopoly of Snezhnevskyism facilitated the State’s embrace of psychiatry to stifle dissent. In Nazi Germany, the eugenic movement, led in part by distinguished academic psychiatrists, was the foundation on which Hitler could erect his murderous edifice. Thus we see that psychiatry is not necessarily an innocent victim when forces beyond its borders seek its connivance to pursue pernicious goals.”

“Snezhnevskyism” is a reference to Soviet psychiatric policies based on the doctrines of Professor Andrei Snezhnevsky, described as “an architect of the diagnostic schema which facilitated the Soviet misuse of psychiatry for political purposes”. Snezhnevsky, according to Professor Bloch, crafted the 87

reasons that a dissident could be labeled as schizophrenic because of the political beliefs and behaviour, doing this over a period of thirty years during which he created new categories such as “sluggish schizophrenia” which could be diagnosed in people who appeared quite normal to the “untrained eye”.

Professor Bloch explains:

“In essence, he devised concepts which profoundly shifted the way the condition was used clinically. This was no mere academic exercise. Several crucial repercussions eventuated: (i) schizophrenia was always genetically determined; (ii) although its features might only manifest intermittently, the biological foundation of the illness always remained; (iii) recovery was not possible; (iv) the main question was the speed with which a patient would deteriorate; and (v) rather sinisterly, because the illness might present with mild symptoms and only progress later, schizophrenia was much more common than previously thought.” (p.174)

The Annual Report of the Mental Health Review Board (1998) states that 65% of patients seen at hearings had been diagnosed with schizophrenia, with another 9% as having “schizoaffective disorder” and 11% with “bipolar affective disorder” (BAD). A disturbing perspective is presented of one of these cases, which is amongst 21 of the 4827 cases selected for presentation in the annual report, of a young man diagnosed as schizophrenic for what are common new age ideas:

“The patient had been diagnosed as suffering from schizophrenia with fixed delusional symptoms. He was preoccupied by his space and research project which involved making further contact with aliens from another planet and believed he and his girlfriend were the living embodiments of people who had been burnt to death as witches in the 17th century. He told the Board he had communicated with aliens from another planet via dreams and astral travel. He did not believe he was mentally ill but was being persecuted for his religious beliefs.” (p.33) 88

The Board, which had “considered whether the patient’s beliefs could be characterised as religious” decided that it did not matter whether or not they were religious, since “even if [the patient’s] beliefs were “religious”, the Board finds that aspects of [the patient’s] “religious practice”, namely his interaction with aliens, falls properly into the category of hallucinations, rather than mystical experience with the supernatural…”. The appeal for release was rejected and the Mental Health Review Board decided that “even were his beliefs to be characterised as “religious”, the Board can and does take them into account, along with these other factors, to determine [the patient] to be mentally ill.”

The Mental Health Review Board hearings are usually held in a room at the same hospital where the patient is held, and may have been held for several weeks or months, and some people have been kept on involuntary status for several years with plans to continue certification indefinitely, against which practice no real protections currently exist. It is important to note that these are not dangerous, violent people who have murdered people or even broken the law. They are usually young people who have been diagnosed as schizophrenic because of their beliefs and behaviour and refuse to accept the label and the crippling drugs that have been forced into them (usually by injection if they refuse to swallow them), usually in huge doses and in locked wards of psychiatric hospitals.

Despite claims of independence and impartiality, the Mental Health Review Board is closely associated with the Public Hospital Psychiatry Departments (in which hearings are held) which, in conjunction with the Victorian Department of Human Services and Commonwealth Department of Health, implement the National Mental Health Strategy, which was launched in 1994 during the last year of Paul Keating’s Labour Government. This Federal (Commonwealth) Labour Government, in which Dr. Carmen Lawrence (who has a psychology degree) was the Minister for Health, made many changes in the Mental Health System that gave senior psychiatrists more power and money and this trend has continued under John Howard’s Liberal Government.

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The National Mental Health Strategy was introduced in 1994 as a joint Federal, State and Territory Government project. According to the Director of the Research and Outcomes Evaluation Section of the Mental Health Branch of the Commonwealth Department of Human Services and Health, in a letter dated 6 March 1996, “the Commonwealth Government has provided $269 million for the reform of mental health services, of which $189 million has been allocated to state and territory governments to achieve these aims.”

The majority of this money has gone into restructuring of the existing mental health system, including the formation of the Mental Health Council, integration of “community psychiatry services” and the construction of several new psychiatric institutions, including a new 135 ‘bed’ forensic psychiatry hospital in Yarra Bend Park, adjacent to the Fairfield Infectious Diseases Hospital. The lack of public consultation and sinister degree of secrecy concerning this major construction project is predictable when the history of forensic psychiatry in Melbourne is known.

“Forensic psychiatry” literally means “law-related psychiatry”, but has evolved from the branch of the public psychiatric system that diagnosed and treated people labeled “criminally insane” in “asylums for the criminally insane”, as well as psychiatric treatment (meaning drugs and/or electroconvulsive treatment) to prisoners within the prisons system. It has, for a number of years, been impossible to obtain records of how many people are given electroconvulsive treatment (ECT, or electroshock treatment) in public hospitals in Australia, but it is known to be several hundred every week. In recent years it has been promoted in Australia, not as a last resort, but as important first line therapy for particular psychiatric conditions, particularly depression, but the treatment is also given for “mania” and “schizophrenia” as well as “schizo-affective disorder” and when injected drugs have failed to produce “improvement” in behaviour.

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The prisons system in Australia is closely linked to the public psychiatric system, and both are integrated with police operations. There are several possible points of referral to the psychiatric system from the police. The “Protocol Between Victoria Police and the Victorian Department of Health and Community Psychiatric Services Division” of 1995 provided a list of “indicators for referral to mental health services”. The police members are instructed to contact mental health services if one or more of the following are thought to apply: Where a person is ‘known’ to have a mental illness and

 Has a history of violence or is a current threat to the safety of others

 Is a serious threat to property

 Shows significant self neglect

 Has a high level of distress

Or is a person who:

 Has a history or presents a current threat of deliberate self harm

 Is behaving in a bizarre or unusual way

 Is displaying gross mismanagement of personal affairs as a consequence of an acutely disturbed mental state.

If the person is held in police custody or imprisoned by the courts, they may still be subject to psychiatric drug treatment. As Professor Paul Mullen writes in Foundations of Clinical Psychiatry: 91

“Psychiatrists also became involved in the care of those in prisons who though not so disordered as to have been found insane were sufficiently disturbed as to require treatment. The role of psychiatrists now includes a wide range of advisory and therapeutic functions at almost every level of the criminal justice system.” (p.322)

The word “care” is used very loosely. The prisons in Australia are not intended for the care of people, they are intended for punishment. The punishments are termed “custodial sentences” and are the result of “judgements” of guilt. Incarceration is unpleasant and widely recognised to be unpleasant, not least of all because of the environment in which “offenders” are held. One has reason, then, to doubt a stated intent to “care for” rather than contribute to this punishment. Painful, crippling injections, electric shocks to the head and permanent labels of “mental disorder” are indeed cruel punishments. Professor Mullen uses the term “mental disorder” repeatedly in the text, but makes a mess of defining the term:

“Mental health legislation varies between definitions which leave the issue to the medical profession and those which state clear criteria with the intention of placing a brake on medical discretion. The latter attempt to wrest decision-making from the medical and vest it in the legal profession rarely succeeds for it simply translates the decision about who is mentally ill into a decision about who is and is not deluded, hallucinated or whatever. In a number of jurisdictions antisocial personality disorder is specifically excluded from the forms of disorder justifying committal.” (p.335)

“Antisocial personality disorder” is described, in a previous chapter of Foundations of Clinical Psychiatry, as follows:

“People with this disorder manifest pervasive irresponsible and antisocial behaviour in adult life. In their childhood, lying, truancy and vandalism are common. In adulthood they cannot hold steady employment, fail to maintain monogamous relationships and behave irresponsibly. They frequently break the law, are involved in aggressive outbursts and show little regard for 92

the property of others. They rarely experience remorse. They are reckless and seem unable to plan or parent effectively. They often abuse both legal and illicit drugs in association with complaints of tension, boredom and anger. The disorder is more common in males and is seen in considerable numbers in criminal populations. In their background there may be evidence of Attention Deficit Disorder and Conduct Disorder occurring in childhood. There is an increased incidence of substance abuse and Somatisation Disorder. Relatives also show a high prevalence of Antisocial Personality Disorder and substance abuse.” (p.192)

Associate Professor Jayashri Kulkarni who authored the above and the chapter on “personality disorders” in Foundations of Clinical Psychiatry from which it is quoted is one of the few female psychiatry professors in Australia, and is, with Professors Graham Burrows and Robert Adler, a “ministerial nominee” on the “psychosurgery Review Board of Victoria”. The Psychosurgery Review Board is co-administered with Mental Health Review Board. Graham Burrows is the head of the Mental Health Foundation and the Department of Psychiatry at the Austin and Repatriation Hospital at Heidelberg, Melbourne, and Robert Adler is, in addition to being a “professor of child psychiatry”, is the psychiatrist on the Medical Practitioners’ Board of Victoria.

Professor Adler co-authored the chapter on “Child and Adolescent Psychiatry” in Foundations of Clinical Psychiatry. In it the American Psychiatric Association’s recent labels for “delinquent” (or, more accurately, disobedient) children, “oppositional defiant disorder” and “conduct disorder”, are described in a single passage, providing an unpleasant stereotype for the impressionable minds of medical students:

“This disorder is characterised by negativistic and defiant behaviour which is excessive for the child’s developmental stage and has been present for over six months. There is debate as to whether it is simply the early manifestation of Conduct disorder. Certainly many children who present with more serious antisocial behaviour associated with the latter have a past history of hyperactivity and negativism. Stealing, lying, running away from home, truancy and physical 93

aggression are common among conduct-disordered children, who often show little remorse or concern for the feelings of others. Conduct disorder is described as socialised or unsocialised depending on whether the children commit their offences alone or in company. A proportion of cases proceed to more serious offending in later adolescence and Antisocial personality disorder in adulthood.” (p.281)

It is not surprising that the authors have difficulty differentiating “Oppositional defiant disorder” and “Conduct disorder”. There is hardly any difference between the two: they are both stigmatising labels for “naughty children and adolescents”. These are “disciplinary diagnoses”, social labels with deeper political significance and implications. Together with “Attention Deficit Disorder” (ADD) and AD/HD (Attention Deficit/Hyperactivity Disorder), these are the most likely diagnoses that troubled (or troublesome) children receive if they are introduced into the psychiatric system.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) defines Oppositional Defiant Disorder as follows:

“The essential feature of Oppositional Defiant Disorder is a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least six months (Criterion A) and is characterized by the frequent occurrence of at least four of the following behaviors: losing temper (Criterion A1), arguing with adults (Criterion A2), actively defying or refusing to comply with the requests or rules of adults (Criterion A3), deliberately doing things that will annoy other people (Criterion A4), blaming others for his or her own mistakes or misbehavior (Criterion 5), being touchy or easily annoyed by others (Criterion A6), being angry and resentful (criterion A7), or being spiteful or vindictive (Criterion A8).” (p.91)

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It is assumed that children should obey adults, especially “authority figures” (including psychiatrists), without question. These same children are stigmatised as being spiteful, intentionally annoying, unreasonably resentful, irritable and angry. Their understandable reluctance to accept the label of “defective person” which is forced on them is explained away as if this is part of the abnormality:

“Usually individuals with this disorder do not regard themselves as oppositional or defiant, but justify their behavior as a response to unreasonable demands or circumstances” (p.92)

Conduct Disorder is described in the DSM IV as a mental disorder distinct from Oppositional Defiant Disorder, although the authoritarian attitudes involved in creating the label are evidently very similar:

“The essential feature of Conduct Disorder is a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated (Criterion A). These behaviors fall into four main groupings: aggressive conduct that causes or threatens physical harm to other people or animals (Criteria A1-A7), nonaggressive conduct that causes property loss or damage (Criteria A8-A9), deceitfulness or theft (Criteria A10- A12), and serious violations of rules (Criteria A13-A15). Three (or more) characteristic behaviors must have been present during the past 12 months, with at least one behavior present in the past 6 months. (p.85)

Inconsistently, but for obvious reasons, given the authors of the DSM, the adults who order bombs to be dropped on other countries (or their own country), send young people to kill other young people and order the execution of “prisoners on death row” are excluded from a diagnosis of “conduct disorder”. The scientists who infect innocent young animals with Ebola virus and other killer-viruses are also spared a diagnosis of “conduct disorder”: the label is intended with other targets in mind.

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The DSM explains, without declaring the social, racial and cultural prejudices (let alone the age-ist ones) underlying the practical application of this label, the collection of “behaviours” which are to be expected in children unfortunate enough to be called “conduct disordered”:

“Children or adolescents with this disorder often initiate aggressive behavior and react aggressively to others. They may display bullying, threatening, or intimidating behavior (Criterion A1); initiate frequent physical fights (Criterion A2); use a weapon that can cause serious physical harm (e.g., bat, brick, broken bottle, knife, or gun) (Criterion A3); be physically cruel to people (Criterion A4) or animals (Criterion A5); steal while confronting a victim (e.g., mugging, purse snatching, extortion, or armed robbery) (Criterion A6); or force someone into sexual activity (Criterion A7). Physical violence may take the form of rape, assault, or in rare cases, homicide.” (p.86)

In a single masterpiece of stigmatisation, children who “break rules” or are “cruel to animals” are placed in the same category as rapists and murderers. These bad children grow into bad adults according to the DSM IV, which claims that most of the adults who have “Antisocial Personality Disorder” previously display “symptoms” of conduct disorder when they are children:

“For this diagnosis to be given, the individual must be at least 18 years (Criterion B) and must have had a history of some symptoms of Conduct Disorder before age 15 years (Criterion C). Conduct disorder involves a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. The specific behaviors characteristic of Conduct Disorder fall into one of four categories: aggression to people and animals, destruction of property, deceitfulness or theft, or serious violations of rules.” (p.646)

To make sense of “conduct disorder” one must first decide what the “basic rights of others” are. The United Nations Universal Declaration on Human Rights could be used as a guide. Article 3 states that 96

“everyone has the right to life, liberty and security of person”. This is surely an indisputable and fundamental human right. A child who takes the life of another person may be diagnosed as having “conduct disorder”, according to the DSM IV, with good reason, but this is merely a description of the crime, not an explanation of the cause of the crime. “Oppositional Defiant Disorder” is not an explanation either: it just means that the child concerned refuses to obey the orders he or she is given. This may occur for any number of reasons. Neither children nor adults enjoy being given orders, as a rule. People usually prefer being asked to being commanded. Rules may be trivial, unreasonable or harmful. Rules are, moreover, a social phenomenon, not a medical one.

One of the rules that children and adolescents are expected to obey, to avoid a diagnosis of “conduct disorder” (or “antisocial personality disorder” in adults) concerns violence. This includes physical violence and emotional violence (outbursts of anger or verbal aggression). Even “passive aggression” can be viewed as evidence of “mental disorder”. Violence and cruelty to animals can also be diagnosed. Yet children as a whole are subjected to a constant (and escalating) barrage of violent images and ideas, aggressive modes of speech and behaviour from television and video programs, as well as from adults in real life. They are presented with self-mutilating role models like ‘Marilyn Manson’ who scream or growl lyrics about killing people, hating people and destroying life. They are fed “sound bites” and have their concentration interrupted every few minutes with “commercial breaks” and are then labelled with “attention deficit disorder” if they fail to concentrate in class. They are brought up watching television shows glorifying a promiscuous lifestyle and are then diagnosed as “mentally ill” or “mentally disordered” if they adopt one themselves. They are given addictive drugs (including amphetamines) from their early childhood and then labelled “substance abusers” if they ingest or inject the same drugs (or other drugs) later in life.

Violence also comes in many forms which are not covered by the DSM, which also fails to mention needles as possible dangerous weapons. It is also known that amphetamines, which are routinely prescribed to children as young as four years old in Australia and the USA for AD/HD are notorious for causing violent behaviour in both adults and children. Amphetamines were invented about 100 97

years ago and were first used to attempt to control the behaviour of “hyperactive children” as long ago as the 1940s. It was a largely unsuccessful experiment, not least of all because amphetamines were found to be highly addictive, and to cause psychosis and aggression. Methyl phenidate (Ritalin, from Novartis) is the most prescribed ‘modern’ stimulant for children diagnosed with ADD or AD/HD. It is also an amphetamine-like drug, although it is less addictive than dexamphetamine, which is also prescribed for ADD and AD/HD.

In the 1970s and 1980s, “true hyperactivity”, as it was then called, was considered to be a rare condition, affecting about one in two hundred children (0.5% of children). These children were said to show a ‘paradoxical’ response to stimulant drugs (specifically amphetamines), but the prescription of these drugs was restricted to psychiatrists (who were also allowed to prescribe them for ‘narcolepsy’) and paediatricians. Children and adolescents (or adults) who obtained amphetamines by other means were deemed to be committing a crime so serious that they could be sent to jail for it. Suddenly, in the early 1990s, however, whilst maintaining the “illegality” of “black market” amphetamines, a huge campaign was mounted to increase the “legal market” for amphetamines. The target population was children.

The first step, as with the marketing of any new diagnosis, was to claim that ADD is often undiagnosed and is actually much commoner than previously supposed. ADD (AD/HD) was now said to affect up to 5% of children, a 10-fold increase on what was claimed a few years earlier. No cause for an increase in the disorder was identified, however, and no explanation put forward for the sudden increase in prescription of amphetamines. Furthermore, the well-recognised addictiveness of these drugs was denied by senior paediatricians and psychiatrists.

In a seminar for general practitioners masquerading as “medical education”, Professor Ernest Luk, professor of child psychiatry at Monash University admitted that drug prescription for AD/HD had 98

increased by 2000% between 1988 and 1994, and a further 700% from 1993 to 1995. The talk was given in 1997, and included the promotion of a range of drugs, including stimulants, clonidine (an old anti-hypertensive drug now relaunched), tricyclic antidepressants and SSRI antidepressants. Even “low dose neuroleptics” (dopamine-blockers) are suggested.

Professor Luk provided notes to accompany his seminar, which promoted a “genetic factor for AD/HD”, but listed other aetiological factors as brain damage, toxic substances, dietary factors and psychological factors. Television and sensory overload are not mentioned as psychological factors, which are listed as “adverse upbringing experience” and “child rearing practice”. Only “lead” and “foetal alcohol syndrome” are considered as possible “toxic substances” which can contribute to the problem. Amphetamine addiction is not mentioned, and the recognised fact that a disproportionate number of children who have been diagnosed as suffering from AD/HD develop problems with “substance abuse” is blamed on the condition itself, and not the practice of prescribing addictive drugs to young children.

Dr John Court, a senior paediatrician at the Royal Childrens’ Hospital and Board member of the Medical Practitioners’ Board of Victoria repeats this claim in The Puberty Game published by Harper Collins in 1997. He is explicit about how safe amphetamines are:

“Dexamphetamine has been used for children with ADD for over fifty years, and there is no evidence that it has led to dependence or addiction. Both Ritalin and Dexamphetamine have been highly researched, and long-term harmful effects have not been found. These medications are now so widely used, particularly in the USA, that there is considerable experience over many years in their use and confidence in their safety.” (p.156)

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He then goes on to describe a series of “side effects” which should cause serious concern about long- term damage as well as immediate risk:

“There are some side effects that may occur with the medication but usually settle down quickly and seldom last more than a few weeks at most. These include some loss of appetite. With careful introduction of the tablets in correct dose, children usually notice very little change, and the effect wears off in time for the evening meal. Dexamphetamine may lead to some difficulty in getting to sleep, but only if the tablet is taken rather late in the day. Sometimes, in my experience, children get an occasional headache or abdominal pain in the first few days, though these don’t persist.

“Sometimes pre-teens and teenagers can get rather depressed when they start the medication. In younger children this is seldom a problem, though they can be rather emotional at first. Older teenagers may become quite depressed, perhaps because the tablets make them focus on their past failures and faults. Depression is perhaps the most significant side effect of stimulant medication at this age.

“It has been reported that the stimulants may slow down growth. This should not be a problem if the medication is used properly, but we always monitor growth with any medication given to children. It has been shown that even if growth has been slowed, children catch up later, and adult height is not effected [sic].” (p.156)

It is surely a big problem if drugs which cause depression are given to children when the incidence of childhood depression and suicide has been steadily rising in both the USA and Australia. It is interesting that Dr Court recognises that taking tablets (to ‘improve behaviour’) makes children focus on their past failures. This is not, obviously, a pharmacological effect of the drug: it is due to the diagnosis and the fact that they are being compelled to take a tablet because of “past failures and faults”. John Court even admits that: 100

“It’s hard to resist the comment ‘Have you had your tablet today, Peter?’ whenever an ADD child misbehaves.”

The paediatrician’s strategy to ensure compliance in drug taking is an effective technique if one wants children to develop a misguided enthusiasm for taking pills:

“I sometimes call the stimulants ‘concentration pills’ that only the best kids are allowed to have.” (p.155)

Another keen promoter of the “AD/HD” diagnosis and the use of stimulant drugs in children is Dr Christopher Green, author of Toddler Taming and other books about bringing up children. In 1998 he authored an article in Modern Medicine titled “Attention deficit hyperactivity disorder – clearing the confusion”. Perhaps better sub-titled “refuting the criticism”, the article seeks to reassure doctors and parents about the safety of stimulant drugs, while legitimising what is clearly a vague, subjective and stigmatising label. He states “the cause” of the condition with authority but a noticeable lack of evidence:

“Until relatively recent times, professionals blamed the parents’ attachment or relationships for causing ADHD behaviours. Others said that ADHD was due to additives in food. Now we know that neither of these is the cause, although the standard of parenting and some food substances may influence already existing ADHD. Two things are certain: firstly, ADHD is strongly hereditary and, secondly, it is a biological condition.”

Dr Green fails to recognise the propensity of the medical profession to see what it looks for when he claims that “heredity of the condition is obvious as so many sufferers have a parent or close relative who has a similar problem”. Given the broad range of “behaviours” which can be viewed as 101

‘symptomatic’ of AD/HD, it is not surprising that once one member of a family has been diagnosed, others with ‘similar’ behaviour can be found. Green admits that the “presentation varies considerably”. He writes:

“Most parents present a restless, intrusive, unthinking child. Others tell of no obvious behaviour problems, just a child who finds it hard to remember, to stick at a task and to maintain work output at school. Some also have problems of dyslexia, language disorder or clumsiness. Others are impossibly oppositional and a few have extreme behaviour that has placed them in trouble with the law.”

Green has difficulty explaining how it is that all these different behaviours are caused by the same “disorder” or how it is that “stimulant medication” is miraculously able to “control the problem”. He tries hard to validate his position that this “disorder” (which is diagnosed on the basis of unwanted behaviour) is a “biological condition”. By this he means that it is caused by dysfunction of the brain (a similar label, ‘minimal brain dysfunction’, was used for many years). He claims that this has now been “proved”. He writes:

“For years it was presumed, but not proven, that ADHD is caused by a minor difference in brain function. Now this can be shown by imaging techniques such as PET, SPECT, and volumetric and functional MRI. In ADHD, scans using these techniques show a slight difference in function and anatomy in the behaviour-inhibiting areas of the brain (the frontal lobes and their close connections). The mechanism of this underfunction seems to be caused by an imbalance of the neurotransmitters noradrenaline and dopamine. The effect of stimulant medications, which are used to treat ADHD, is to increase the production of these natural chemicals.” (p.119)

As in the “dopamine theory of schizophrenia” and the “serotonin theory of depression” (which followed the noradrenaline theory of depression), the neurotransmitter theory of ADHD is inexcusably 102

reductionist, and merely follows the use of drugs which are known to affect these chemicals. One wonders how Professor Luk can justify the use of ‘low dose neuroleptics’ (which block dopamine receptors) for the same condition that Green claims is caused by lack of the same chemicals. In truth, neither an excess nor a deficiency in any of these chemicals has been detected in untreated “ADHD sufferers” (or ‘schizophrenics’ or ‘depressives’) and the chemical imbalance theory is merely one of inference secondary to known pharmacophysiology.

John Court, in The Puberty Game, repeats the chemical imbalance theory, while presenting a regressively mechanistic, reductionist model of mental function:

“The rationale for giving medication to children with ADD is this: the brain acts like a computer in many ways, but its function depends on chemical substances called neurotransmitters. Neurotransmitters help transmit messages between nerve cells, which are called neurones. Neurones are the basic units of the nervous system, including the brain. These neurotransmitters ensure that messages are sent through the nervous system in an orderly and efficient way.

“We believe that in ADD some of these neurotransmitters are not functioning properly. It seems likely that the brain is not making them efficiently, or in sufficient quantity. What we do know is that it is possible to increase the efficiency of these neurotransmitters through stimulating them by medication. This seems quite logical, and there is ample experience to show that this stimulant treatment is one that works in most cases, and is safe.” (p.153)

The “Turning Point Alcohol and Drug Centre” in Melbourne lists some of the “common symptoms in amphetamine withdrawal” in their 1996 booklet titled, “Getting Through Amphetamine Withdrawal”. Days 1 to 3 (described as ‘the crash’) are typified by exhaustion, increased sleep and depression. On days 2 to 10 the symptoms include, “strong urges (cravings) to use amphetamines, mood swings (alternating between feeling irritable, restless, and anxious to feeling tired, lacking energy and 103

generally run down), poor sleep, poor concentration, general aches and pains, headaches, increased appetite and strange thoughts (such as feeling that people are ‘out to get you’ misunderstanding things around you, such as seeing things that aren’t there). The withdrawal symptoms, according to the Turning Point doctors, “start to settle down” in 7 to 28 days, during which time common symptoms include, “mood swings (alternating between feeling anxious, irritable or agitated, to feeling flat and run down), poor sleep and cravings”. It is easy to see how the withdrawal symptoms of stimulant drugs can be attributed to the conditions they are claimed to be treating: they sound remarkably similar to the “symptoms” of “attention deficit/hyperactivity disorder”.

The concept that initiating young children and their parents (and siblings) into taking tablets to improve concentration and behaviour could lead to subsequent dependence on drugs generally is not difficult to understand. The psychological ramifications (for the whole family) of singling out individual children to blame for arguments and discordance in the family (or classroom) is cruel and socially destructive. I have not read a single article blaming boring school curricula for lack of attention from children, although ‘inconsistent discipline from parents’ is blamed as a ‘contributing factor’ at times. Furthermore, the medical profession continue to turn a blind eye to the part they play in creating drug addiction, despite growing concerns from the public as well as from dissidents within the profession. Christopher Green refutes such concerns in “Attention deficit hyperactivity disorder – clearing the confusion”:

“Stimulant medication was first used for ADHD in 1937. The drug Ritalin has been used since 1958. These preparations have now been extremely well researched and proven; currently there are over 150 published papers showing that stimulants are effective and safe in ADHD. Yet there are still people in this country who state that stimulants are new, controversial, addictive, dangerous and unproven. These ideas are out of date in 1998.” (p.126)

It is not true that “stimulant medication was first used for ADHD in 1937”. In 1937, “ADHD” did not exist. It is true, however, that some children were experimented on with amphetamines, and that these 104

children were labelled as ‘hyperactive’. The construction of the “new disorder” which is now accepted so glibly as a distinct “biological condition” by Dr Green and others, was formally announced in the 1994 Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association (APA). The “disorder” is described as follows:

“The essential feature of Attention-Deficit/Hyperactivity Disorder is a persistent pattern of inattention and/or hyperactivity that is more frequent and severe than is typically observed in individuals at a comparable level of development (Criterion A).”

“Hyperactivity” is described thus:

“Hyperactivity may be manifested by fidgetiness or squirming in one’s seat (Criterion A2a), by not remaining seated when expected to do so (Criterion A2b), by excessive running or climbing in situations where it is inappropriate (Criterion A2c), by having difficulty playing or engaging quietly in leisure activities (Criterion A2d), by appearing to be often “on the go” or as if “driven by a motor” (Criterion A2e), or by talking excessively (Criterion A2f).” (p.79)

It appears that the psychiatrists who decided on these criteria were brought up in the school that insists that “children should be seen but not heard”. Further evidence of “hyperactivity” is evidenced in children who “often get up from the table during meals …or while doing homework”. Far from recognising any deleterious effects of television on concentration, according to the DSM IV, getting up often “while watching television” is further evidence of abnormality.

Incredibly, the psychiatric profession, and medical profession generally, have failed to grasp the influence of television on childrens’ behaviour. Rather than attributing increasing violence at younger ages to increasingly violent television programs, video games, computer games and films, vague 105

“chemical imbalance theories” and statistics purporting to demonstrate “genetic factors” are put forward, not as “possible and partial explanations” but as “proven fact”. Science fiction movies about extraterrestrial invasions are all the rage, but if an adolescent (or even a child) seriously believes in “UFOs”, he or she can be diagnosed as having “schizophrenia” according to modern psychiatric criteria.

The diagnoses of “child psychiatry” provide a justification to use the full spectrum of adult psycho- active drugs on children. In essence the “related disorders” of AD/HD, Oppositional Defiant Disorder and Conduct Disorder are pseudoscientific gradings of delinquency. A child with AD/HD is bad, but not as bad as a child with Oppositional Defiant Disorder. These children are not as bad as those with Conduct Disorder. The latter is the favoured label for children whose behaviour is deemed bad enough to go to prison for. Not surprisingly, many adults who are labelled as having “antisocial personality disorder” have previously been designated defective as children with one of the labels, and been early victims of psychiatric stigmatisation.

“Antisocial personality disorder”, which is the new label for people who used to be described as “sociopaths”, is not a nice thing to be diagnosed with. The term implies that the person has no conscience, and does not feel remorse for causing the suffering of other people or animals. There is no doubt that such people exist, however the label is selectively applied for those caught up in the prisons and psychiatric systems, and not those who make the sort of rules that allow the poisoning of European rivers with cyanide, the distribution of landmines or the incarceration of children. Men who send young men off to war and inject them with chemicals for corporate profits, or create depression and suicide for personal profit are also spared a diagnosis of “Antisocial personality disorder”, together with men who design taxes that further impoverish the poor and dispossessed in countries with an offensive disparity between the conditions in which rich and poor members of society live.

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The DSM IV defines Antisocial Personality Disorder as follows:

“The essential feature of Antisocial Personalty Disorder is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.

“This pattern has also been referred to as psychopathy, sociopathy, or dyssocial personality disorder. Because deceit and manipulation are central features of Antisocial Personality Disorder, it may be especially helpful to integrate information acquired from systematic clinical assessment with information collected from collateral sources [hearsay and rumour].

“For this diagnosis to be given, the individual must be at least age 18 years (Criterion B) and must have had a history of some symptoms of Conduct Disorder before age 15 years (Criterion C).”

The “long term unemployed” are targetted with this horrible label, which does not take into consideration the frustrations, loss of self-esteem and boredom which can result from being denied rewarding and meaningful activity:

“Individuals with Antisocial Personality Disorder also tend to be consistently and extremely irresponsible (Criterion A6). Irresponsible work behavior may be indicated by significant periods of unemployment despite available job opportunities, or by abandonment of several jobs without a realistic plan for getting another job. There may also be a pattern of repeated absences from work that are not explained by illness either in themselves or in their family.” (p.646)

The hypocrisy of the description of “Antisocial Personality Disorder” becomes more obvious when one remembers that infamous reproach to the Australian people from ex-Prime Minister Malcolm Fraser, 107

now head of CARE Australia: “Life was not meant to be easy”. Such statements are apparantly a feature of “Antisocial Personality Disorder”, according to the American Psychiatric Association’s DSM IV:

“Individuals with Antisocial Personality Disorder show little remorse for the consequences of their acts (Criterion A7). They may be indifferent to, or provide a superficial rationalization for, having hurt, mistreated, or stolen from someone (e.g., “life’s unfair,” “losers deserve to lose,” or “he had it coming anyway”). These individuals may blame the victims for being foolish, helpless, or deserving their fate; they may minimize the harmful consequences of their actions; or they may simply indicate complete indifference.” (p.646)

The DSM IV stigmatises the victims rather than addressing the causes of poverty. Under “Specific Culture, Age and Gender Features” the textbook claims:

“Antisocial Personality Disorder appears to be associated with low socioeconomic status and urban settings. Concerns have been raised that the diagnosis may at times be misapplied to individuals in settings in which seemingly antisocial behavior may be part of a protective survival strategy. In assessing antisocial traits, it is helpful for the clinician to consider the social and economic context in which the behaviors occur.” (p.647)

The textbook follows with a suggestion that the label is not applied often enough to women:

“Antisocial Personality Disorder is much more common in males than in females. There has been some concern that Antisocial Personality Disorder may be underdiagnosed in females, particularly because of the emphasis on aggressive items in the definition of Conduct Disorder.” (p.647)

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The Australian textbook Foundations of Clinical Psychiatry expresses different concerns about “antisocial personality disorder”:

“The diagnostic criteria consist of little more than a catalogue of obnoxious and disruptive behaviours which, it has been suggested, far from defining a clinical disorder merely attempts to ‘medicalise evil’. Many clinicians wish to banish those with APD (antisocial personality disorder) from the realm of medicine and consign them as social deviants to the police and justice systems.” (p.339)

A “case example” is presented of a person “typifying” the label in what is claimed as an attempt to establish that in addition to “disturbance in behaviour” such people also have a “disorder of mental function”:

“A man in his mid-twenties was first encountered after slashing his wrists and abdomen while in prison where he was awaiting trial on charges of burglary. He came from a disorganised home in which he had been physically and sexually abused. At school he had been a ‘behaviour problem’ and had been referred to the educational psychologists for what we would now term Conduct Disorder with features of Attention Deficit Disorder. He left school at fifteen with no qualifications despite having above average intellectual ability. He was involved in petty theft both at school and in boys homes where he spent part of his adolescence. In his teens he abused alcohol and solvents. He had appeared before the courts on numerous occasions for theft, assault, indecent assault and car conversion. He had been admitted to psychiatric hospitals on two occasions, after an overdose and after slashing his arms and legs with a razor. Both episodes followed the breakdown of relationships with girlfriends.

“He presented as an articulate man with considerable charm which contrasted with his grim appearance, not improved by tattoos over his face and hands. He acknowledged recurrent periods of depression, usually lasting only hours and never more than days. During these 109

episodes of despondency he would experience self-destructive urges combined with violent fantasies. He had a pervasive suspiciousness of others with a tendency to refer any chance remark or overheard laugh to himself. This led to confrontations where he would accuse and occasionally strike others. Sexual relationships soon disintegrated because of his excessive jealousy. On one occasion when in prison he had entered a disturbed state with bizarre persecutory beliefs and pseudo-hallucinations, but this had rapidly resolved on transfer to the hospital wing. His behaviour was impulsive, unpredictable and often destructive of his own interests as of the common good. Police, prison authorities and most ordinary people he came into contact with considered him ‘mad’ because of his unpredictable, self-destructive and impulsive behaviour. Psychiatrists had on several occasions declared him to be sane and to have a personality disorder. The extensive abnormalities in his state of mind as well as his behaviour carried no weight with the doctors bacause they were not the types of disturbance found in the schizophrenias or other psychotic disorders.” (p.339)

Professor Paul Mullen, who presents the “case history”, omits some valuable information about this man that could help understand his behaviour. It is easy to see “unpredictability” in people one does not understand. What happened to this man’s family? Did he have any siblings, and if so, where are they and what is his relationship like with them? Was he a stolen child? What colour was his skin? What religious beliefs, if any, did he have? Was he addicted to drugs, like much of the prison population? What drug treatment had he been given in the past? Had he ever been given ECT? What kinds of punishments was he subjected to in the boys’ homes and prisons where he had obviously spent much of his youth? What had he stolen in the alleged ‘burglary’?

Mullen presents this case in this way to illustrate some points of psychiatric dogma. One is that people with “personality disorders” are not “insane”. To put it simply, they are bad, not mad. This means that they can be incarcerated in jails rather than psychiatric hospitals, although they can still be treated with psychiatric drugs. Another point the professor is trying to illustrate, is that people who “develop” this adult personality disorder demonstrate “symptoms” of Conduct Disorder earlier in life. Despite the fact 110

that the ‘case example’ may be fictional or fictionalised, the story of this young man does illustrate an all too common journey for unwanted children in Australia. Disobedience, disorder label, psychiatric treatment, loss of self esteem, drug addiction, depression, alcohol abuse, aggression and violence, police punishment, custodial punishment, worsening of drug addiction, self-harm, combined prison incarceration and punitive psychiatric treatment. Not surprisingly, this journey often ends in early death, often attributed to suicide.

Paul Mullen is a senior professor of forensic psychiatry at Monash University and Director of Forensic Psychiatry Services in Victoria. He authored the chapter on Forensic Psychiatry in this textbook. He describes his “specialty” as follows:

“Forensic psychiatry is that area of psychiatry which overlaps with the legal system. Central to it is assessment and treatment of the mentally disordered offender, and provision of expert testimony to both criminal and civil courts. In addition, forensic psychiatrists may become involved in legal issues concerning competence, consent and confidentiality, and malpractice. In recent years forensic psychiatrists have had to care for a wide range of mentally disordered people considered either of such high risk of dangerous behaviour, or so problematic as to be unmanageable in ‘normal’ psychiatric facilities.” (p.321)

Forensic psychiatrists themselves predict “risk of dangerous behaviour” and their opinions on the matter are taken seriously by police and the courts, despite their abysmal failure to make these predictions with accuracy, or their inexcusable failure to abandon racial and cultural prejudices. It is no longer “politically correct” to accuse particular races of violent tendencies, dishonesty or criminality, so modern psychiatric textbooks make much of refuting ‘racialist theories of violence’, preferring class-ist ones instead. The racist prejudices underlying the new theories are poorly disguised however, and the proportion of “blacks” in custody (in Australia, New Zealand and the USA) speaks for itself.

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Professor Mullen writes, under “clinical prediction of dangerousness” that “social background” is an “associated factor” for “high rates of violent behaviour”:

“Those who appear before the courts and populate our penal institutions are drawn disproportionately from lower socio-economic classes. Poverty, though relevant, is less important than a sense of exclusion from the rewards and regard of society. Those disabled by mental illness are often drawn into the impoverished and drifting populations of the excluded and rejected, and with this comes an increased risk of offending, arrest and re-offence. Those who are economically and socially deprived as well as being members of minority groups are at particular risk of offending and arrest, e.g. black Americans, Maori New Zealanders and Aboriginal Australians. Race is not the issue; it is the social and economic conditions under which these racial minorities live. The unemployed, the unmarried or unattached and the socially isolated are all at higher risk.” (p.332)

One of the roles of forensic psychiatrists, according to Professor Mullen is the investigation of “malpractice”. This rarely affects his own profession, but in July 1991 there occurred an exception to the rule. He was called upon by the Director General of Health in New Zealand to investigate the treatment and death of Dolly Jane Pohe at the Psychiatric Unit of Rotorua Hospital, and the practice of “rapid neuroleptisation” at the hospital. Responsible for this abusive practice was the psychiatrist Gil Newburn, who was simultaneously conducting drug-trials-for-profit for several pharmaceutical companies (including the new antidepressant Aurorix, for Roche). Dr Newburn had a treatment for “manic” patients that routinely rendered them comatose with massive intravenous and intramuscular injections of diazepam, chlorpromazine and haloperidol. Dolly Jane Pohe was one of his victims. Although her race is not stated in the report, Pohe is a Maori name.

The committee of inquiry into this death consisted of Paul Mullen, who was then Professor of Psychological Medicine at the University of Otago, and David Bates, a barrister. Despite his advice to students that “a psychiatric report can present them as people with backgrounds, personalities, strengths 112

and weaknesses”, Professor Mullen presented a report that is cold and impersonal, but also negligently omissive. It was, in fact, a cover-up.

Dolly Jane Pohe, whose age, race and family background are not mentioned in the report died on Sunday, 7th April, 1990, after being admitted as an involuntary patient by Dr Newburn on Wednesday, 4th April, three days earlier. During this time she received 10 injections: 4 of haloperidol, 4 of diazepam (Valium), one of chlorpromazine (Largactil) and one of clonazepam (Rivotril). All these drugs are tranquillisers. In addition to this she was given a huge amount of oral “neuroleptics” (dopamine- blockers) including chlorpromazine and haloperidol. This included 400 milligrams of oral chlorpromazine as soon as she was admitted (which was followed by intramuscular injections of 30mg haloperidol and 10mg diazepam an hour later) and 15 mg oral haloperidol later that afternoon.

The next day she was given 15 mg haloperidol at 8.00 a.m., with further doses of the same drug at 1.00 p.m., 3.30 p.m., 6.00 p.m. and 9.00 p.m. At 4.15 p.m. she was punished with intramuscular injections of haloperidol (30mg) together with diazepam (10mg). Her crime was escaping from torture and going down to the pub:

“At 15:30 the security room door appears to have been open and Ms Pohe slipped through and left the ward. The police were notified. She was returned to the ward by the police at 16:15 having been found in a nearby pub, the Palace Tavern. She was given haloperidol and diazepam intramuscularly on return to the security room as she was noted by Dr.Finucane to be more irritable and disturbed. She appears to have settled after the medication until about 18:00 hours when she was noted to be restless and banging on the door. She was threatening to the nursing staff [from behind a locked door] and they recorded anxieties about her potential for physical aggression. Ms Pohe seems to have settled from 19:30 and remained quiet and probably sleeping until 07:00 the next morning.” 113

The next day the torture continued:

“On waking, Ms Pohe appears to have become more restless and disturbed [as one might if one woke in such an environment]. She is described as “aggressive, abusive, violent, unco- operative and physically aggressive towards staff”. At the request of nursing staff Dr.Newburn saw Ms.Pohe in the seclusion room. The trainee intern accompanied Dr.Newburn and described how impressed he was, both with Dr.Newburn’s ability to calm Ms Pohe sufficiently to talk with her and his ability to inject the haloperidol intravenously despite her initial reluctance. Dr.Newburn considered her state to be deteriorating rather than improving and an intravenous injection of haloperidol 35 mgs and diazepam 80 mgs was administered at 09:00 hours. A further 30 mgs of valium was injected by Dr.Newburn at 10:00 hours.”

One thing that is obvious about Dolly Jane Pohe is that she did not want to be locked in a room, and repeatedly banged on the doors, presumably to be let out. This was callously noted as evidence of “aggression, violent behaviour and restlessness”, further evidence of “mania”. It is unclear as to what specific evidence Dr Newburn found of a “deteriorating state” other than that she refused to co-operate with the incarceration and was angered by it, and by how she was being treated. It is relevant that she was calm enough to converse with the doctor before he injected her with the drugs. Maybe she hoped he would let her go home, or at least leave the “security room”. This was not to be the case.

The next day, finding that she was still imprisoned, Dolly Pohe was obviously despairing, but also suffering from poisoning by the drugs she had been given: 114

“On the Saturday morning she was noted to be restless and irritable, banging on the door and angry. It was possible to bath her and she had some breakfast. At about 09:00 she calmed down and appeared to be asleep until 10:20. She was then noted to be in some distress, “wailing sounds” were noted. She then slept until mid-day.

“At 12:00 hours Nurse Young became aware that Ms Pohe was heavily sedated and was apparently having difficulty swallowing. She decided not to administer any further medication and phoned Dr.Finucane to inform him of Ms Pohe’s state and her decision. Dr.Finucane supported her decision.

“At 13:00 hours Nurse Young noted Ms Pohe’s pulse was irregular. She phoned Dr.Finucane to apprise him of the situation. He instructed her to call the on duty house surgeon to request an ECG.”

Dr Finucane “examined” Dolly Pohe at 4.00 p.m., but reassured the nursing staff that although he “found her to be drowsy and unco-operative” he “was able to examine her cardiovascular system” and her pulse was now regular. He thought, however, that the 400 mg of chlorpromazine she had been given in the morning combined with clonazepam may have resulted in a cardiac arrythmia (irregularity) and wrote in the chart, “try to use just haloperidol for rest of day”.

If the evening nurse had the same reluctance to further drug a heavily drugged prisoner as Nurse Young, Dolly Jane Pohe may have survived. Mr Lee, the male nurse who took over the care of Ms Pohe after Nurse Young did not share her concerns. He noted that “whenever Ms Pohe did rouse she showed signs of becoming disturbed again and he felt it was important to maintain the continuity of the sedation effect”. She was given 20 milligrams of haloperidol at 14:45, 19:00 and 22:00, according to the report. She was given another 20 mg of haloperidol at 1.00 a.m. after banging at the door again, this time because she wanted to go to the toilet. When nursing staff entered the seclusion room at 5.15 a.m. she was dead. 115

The report, presented to the Director General of Health (New Zealand) made two recommendations, after a single sentence of “summary”. The summary reads:

“In our opinion there is no prima facie evidence against any person in respect of which a prosecution should be recommended, or in respect of which a complaint should be made under the Medical Practitioners Act.”

The recommendations are as follows:

“(1) We do not recommend criminal prosecution of any person nor complaint against any person under the Medical Practitioners’ Act or Nurses’ Act

(2) We express our regret that there exists no suitable mechanism by means of which civil remedies might be pursued against health care professionals in appropriate cases of which the death of Ms Pohe might possibly be considered an example. We recommend investigation of this deficiency in our civil law with a view to legislative action being taken.”

The psychiatrist who made these recommendations, Professor Paul Mullen, is now one of the senior psychiatrists in charge of the forensic psychiatry system in Melbourne. He is also a Professor of Psychological Medicine (psychiatry) at Monash University, which is affiliated with both the Mental Health Research Institute and the Macfarlane Burnet Centre. It is also affiliated with Monash Medical Centre and the Alfred Hospital, both of which inject people with crippling drugs against their will. Both hospitals also give coercive electoconvulsive treatment. This is what medical students and junior doctors learn to do in Melbourne, since both of these hospitals are “teaching hospitals”.

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Artificial chemicals, whilst mimicking the effects of natural stimulation of neurone cell membrane receptors (at synapses or on the body of the cell) in some ways, behave in fundamentally different ways in the long term. Natural neurotransmitters and neurohormones are constantly recycled by the brain and are also being constantly synthesised from amino acids, which reach the brain through the blood stream. This is a complex and intricate chemical orchestra conducted by the brain, but profoundly influenced and in a real sense controlled by the mind. Both the mind, and the sensitive processes that regulate the biochemistry of the brain can be adversely affected by exogenous (from outside) stimulation of receptors designed for transient stimulation by naturally synthesised and catabolised chemical messengers. These include the endorphins as well as neurohormones and neurotransmitters.

Some of the named neurotransmitters have been increasingly mentioned in ‘popular literature’ and the mass-media in recent years, mainly because of the aggressive marketing of a range of drugs that exert their most obvious effects by increasing and decreasing the activity of neurotransmitters. These drugs include the old and new antidepressants, amphetamines (and related stimulants) and major tranquillisers (‘antipsychotics’ or dopamine-blockers). The older tricyclic antidepressants (such as Tryptanol and Prothiaden) tend to stimulate noradrenaline and serotonin activity, according to pharmacological literature, whilst the newer SSRI antidepressants are claimed by the manufacturers to specifically target serotonin reuptake mechanisms in synapses in the brain, hence the name Selective Serotonin Reuptake Inhibitors.

Prozac was the first SSRI drug to be marketed by a pharmaceutical company, although the chemical precursor of the drug (also the precursor to the euphoria drug “ecstasy”) was discovered several decades ago. Following the unprecedented sales of Prozac by Eli Lilly, the US based drug company that manufactures and sells the drug, several other drug companies have brought out their own SSRIs to get their share of the “depression market”, as their own marketing plans describe the troubled people of the world. SmithKline Beecham, the huge UK-based drug company are one such company, and, in the mid-1990s began an aggressive marketing campaign in Australia and New Zealand for their SSRI antidepressant Aropax, with a particular push for the prescription of the drug by psychiatrists and 117

general practitioners for “panic disorder”. This was done with the assistance of the Mental Health Foundation, headed by Professor Graham Burrows, who endorsed a series of “patient education” leaflets promoting the diagnoses of “depression”, “anxiety”, “panic disorder”, and “obsessive compulsive disorder”(OCD) and the new drugs to treat these conditions (including the ones produced by the sponsor SmithKline Beecham notably Aropax).

The following information was provided by SmithKline Beecham to their sales representatives for Aropax (paroxetine) in New Zealand as part of an intensive marketing campaign for the drug in the 1990s:

“Depression is a condition of the central nervous system-ie the brain. The basic unit of the nervous system is a neurone, which looks like a rod with a swelling at each end. In the body these neurones form long chains, or nerves. In the brain, they form massive, tangled complexes. Chemical impulses pass from neurone to neurone like a bucket-brigade, leaping the tiny gaps between each cell. These gaps are called synapses.

“The most important chemical imbalance that causes depression seems to be related to a substance called serotonin, which is produced by neurones and released into the synapse. Serotonin is necessary as a “medium” for the brain to transmit positive emotions. Without enough serotonin, it is physically impossible to feel happy or content. Serotonin levels are usually kept at the right levels by the neurones themselves, which re-absorb any excess, and release more in case of shortage. In some depressed people, however, the neurones seem to hoard serotonin, letting out only a trickle while aggressively reabsorbing. As a result, the person’s ability to feel happy dries up, and they enter clinical depression.”

This unreferenced and simplistic piece of nonsense fails to mention some important facts about serotonin and distorts others in an inexcusable act of medical and scientific fraud in an effort to promote a drug that specifically targets serotoninergic neurones in the brain. The promotional literature 118

fails to mention that serotonin is manufactured in the gut and nervous system (including the brain) from the dietary amino acid tryptophan, and performs many functions in the body other than being a “happy chemical”, which is what the promotional literature from SmithKline Beecham suggests. This advertising blurb also fails to mention that serotonin is concentrated in the brain in the pineal organ, where it is converted to the neurohormone melatonin, a scientific fact discovered in the 1960s and conclusively proved in numerous studies. The fact that serotonin is concentrated in the pineal where it is converted to melatonin during the night-time hours of darkness is generally not found in literature about Prozac, Aropax and the other SSRI drugs, including information provided by the drug companies to doctors or in the many books and medical articles published about (and promoting) the new psychiatric drugs.

SmithKline Beecham, who are, with the Commonwealth Serum Laboratories (CSL) and the American giant Mercke, the biggest marketers of virus vaccines in Australia, have played a prominent role in the Commonwealth of Australia’s National Mental Health Strategy, and funded or co-funded a range of “public health” and “disease awareness” campaigns and strategies in Australia over the past 10 years. These have included collaborating with the Mental Health Foundation and other “drug foundations” to produce, promote and distribute literature promoting the diagnosis of “panic disorder” for which the new SSRI drugs were being promoted despite conclusive evidence that the drugs can aggravate anxiety immediately after they are started precipitating psychosis and suicide in vulnerable individuals.

Australian ABC reporter Ray Moynihan, in his 1998 book Too Much Medicine? described an elaborate launch of Aropax and panic disorder in Sydney, in 1996:

“One of the top chefs in the country is catering at one of the best venues in the nation. A large gathering of doctors are about to tuck into a $100-a-head meal. The live satellite link with hundreds of their colleagues across Australia is soon to start: another lavish promotional event dressed up as a scientific gathering, courtesy of the pharmaceutical industry. 119

“This 1996 Sydney harbourside dinner was how the drug giant SmithKline Beecham chose to ‘educate’ doctors about the government’s approval of its new antidepressant, Aropax, for the treatment of a psychiatric condition called panic disorder. The night was just one component in a highly sophisticated marketing campaign to promote Aropax and this little-known disorder. The strategy included Panic, the book; Panic, the video; and Panic, the T-shirt.” (p.115)

Moynihan continues to expose just a small amount of the ensuing cost to the Australian community:

“The use of new antidepressants, including ‘Aropax’ and the better known ‘Prozac’, has grown astronomically in Australia since the early 1990s, from 5,000 prescriptions a year in 1990 to over 2.5 million in 1996. ‘Aropax’ is now one of the top-selling antidepressants. And as the number of people using these expensive new drugs has dramatically escalated, so too has the cost to the taxpayer. The new antidepressants now cost the Pharmaceutical Benefits Scheme funded through Medicare over $120 million in 1995-96.” (p.115)

The 1992 SmithKline Beecham marketing plan, sent to the ACACP and HRIC by a human rights worker in New Zealand in 1998, demonstrates a callous disregard for the human beings being targeted to both prescribe and consume this drug. The following extracts show the general tone of the document:

“Task/Assignment

We are to produce a strategy and creative execution to launch Aropax to GPs. 120

For the creative, we need a foundation concept and image, reflected in concept boards for:

A detail aid

An invitation to the launch seminar

An educational mailing pack

Branding advertisements

Thought should also be given to

Leave behinds

Neurone card, showing how the neurone can hoard serotonin

Branded give aways

The client wants to research and test the campaigns submitted. Our concept boards should be designed with this in mind.

Objective 121

Marketing Objectives

Establish SSRI’s as the “future of antidepressant therapy” by educating GPs.

Differentiate Aropax on the basis of its key attributes and strong branding.

As a result, establish Aropax as the SSRI of choice.

Direct marketing Objectives

Teach doctors about SSRIs.

Show why Aropax is the closest thing to an ideal agent.

Generate qualified leads for later sales calls.

Advertising Objectives

Build strong brand awareness of Aropax as the SSRI of choice. As we may

have a standing start race against a similar competitor, all branding must be

strong and emotional.

Build on the educational messages of the direct marketing. 122

Perhaps it is naïve to imagine that the pharmaceutical industry would consider the health of humanity as its primary objective. It is a clear conflict of interest when the same industry is allowed opportunities to promote diseases (especially ‘invisible diseases’) for which the drugs they produce will be prescribed. It is also against the law. The wilful creation of disease, termed biological warfare, is a crime against humanity, and is prohibited by International Laws.

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LEGACIES OF A PRISON COLONY

When the first large asylum was built in Australia, at Tarban Creek in New South Wales, the Superintendent made a requisition that hints at the treatment the inmates were to receive when the “lunatic asylum” opened:

“63 iron bedsteads, six chairs for violent cases, 16 cribs of wood for dirty cases, 12 pairs of leather hobbles of various sizes for males and females, 12 hard belts of strong leather and iron cuffs attached to them with straps, 12 cuffs and belts for the hands in less violent [cases]” (Dax, 1975)

The Tarban Creek Asylum was opened in 1838, and it accepted patients from Victoria who were transported there by ship from Melbourne. The state of Victoria had not yet been founded, and the area was still administered by the British colonists from New South Wales. Prior to this a smaller asylum had been opened in 1811 in New South Wales, before which the insane were kept in jails. The close connection between the prisons system and the psychiatric system has persisted to the present.

The next asylum was built in Tasmania (Van Dieman’s Land) which was then a prison colony along with Norfolk Island, to the east of Tasmania. This occurred in 1829 and was followed by an additional larger asylum at Port Arthur in 1842. The Australian psychiatrist Professor Eric Cunningham Dax wrote of Port Arthur in A World History of Psychiatry (1975):

“In 1842 an asylum was opened at Port Arthur. There were four dormitories, a central hall, 24 cells, and a padded room. One patient spent long hours in a cage. Port Arthur then had an evil reputation, and Britain, in a wave of belated guilt, ordered the penal settlement to be 124

abandoned, so that by 1879 only 64 prisoners, 126 paupers (presumably housed in the invalid block), and 69 lunatics remained. They were called “imperial lunatics”!

“Another matter of psychiatric interest at Port Arthur was an adjacent establishment at Point Puer which contained up to 730 delinquent boys, mostly aged 9 to 18. Some were transported for trivial offences. It appears that Governor Arthur made a real attempt to educate and train them as stonemasons, sawyers, and in other trades.” (p.707)

The training and retraining of young people was one of the many agendas of psychiatrists and mental hygienists, but they had to compete for the minds of the young with the Churches, which had a longer history of both teaching children and looking after the poor and disadvantaged. It was the Anglican Church and the Roman Catholic Church in Australia that controlled most of the primary and high school education in these areas in Australian schools, but this was to change, according to the plans of the mental hygiene movement and medical profession.

One way in which the psychiatric profession formed an unholy alliance with the Anglican and Catholic Churches, was by providing the initial incarceration, enforcement of ‘compliance’ (obedience) and drug treatment of young people and collaborating with Church organizations in their subsequent training in menial occupations, whilst providing on-going supervision and enforcement of drug treatment. Cunningham Dax refers to such programs in From Asylum to Community, and continued developments of this alliance are evident in an examination of today’s youth-training programs and psychiatric treatment and followup programs. Dax wrote, of the then new system in the late 1950s:

“Prior to 1954 there were no full-time chaplains within the mental hospitals. Since that time the Anglican Church have appointed five and the Presbyterians one, and it is hoped that three other full-time chaplains from the Catholic and the Methodist churches and another Anglican will be engaged before long. They are jointly appointed by the Church and the Mental Hygiene Department. There is a chaplains’ advisory committee which discusses the terms and the 125

conditions of appointment, and the training. Opportunities are available for the chaplains of the various denominations to discuss their work together and a series of successful seminars have been held which have extended from a single day up to a full residential week. Three Anglican chaplains have been abroad for training.” (Dax, 1961, p.34)

Dax does not say which countries the chaplains were trained in but it was undoubtedly Britain or America. Dax, who was born in Britain and graduated in medicine at the University of London in 1935, is Anglocentric in his perspective, and, along with common medical views of British and British trained psychiatrists had fundamental belief in “physical treatments” and drug treatment over “talk therapies” and psychotherapy of a more gentle nature. This has been a feature of Australian psychiatry since the time of Cunningham Dax, especially in the public hospital system, where the only treatment is drugs and electric shocks. Psychotherapy is generally held “to not work for serious mental illness”, and “psychoanalysis”, by which is usually meant Freudian analysis, is suspected (with good reason) to confuse the psychotic further. Dax does not mention psychoanalysis, or Freud, and makes only passing references to psychotherapy, which he says the psychologists employed by the Mental Hygiene Authority and public hospitals were actively discouraged from doing. He writes:

“Neither the psychologists nor the social workers are encouraged to do psychotherapy as it is felt that they are more usefully used in their own special fields. On the other hand, it is hoped to extend the group activities for both these associates within their own specialties” (p.34)

In territorial fashion he defines what he sees the role of psychologists to be in this new empire controlled and dominated by psychiatrists:

“Nine years ago there was an establishment of seven psychologists; now there are nineteen. They have not as yet been widely used in the mental hospitals, but more within the clinics and particularly in those for children. The ways in which they have been occupied within the Department are therefore as follows: 126

Intellectual Deficiency. Here the psychologists are particularly concerned with assessing the intellectual abilities of the patient and his capacity for development. They give remedial teaching, so the child may develop to the maximum of his ability. They supervise the patients’ activities so as to direct them towards gaining a therapeutic benefit. They are able to guide the patients into appropriate occupations or activities towards training them to live in the community.

Children. In child guidance clinics some of the psychologists are used for play therapy or counselling, but the practice varies. Intellectual and vocational testing, educational assessment and advice on overcoming difficulties, and remedial educational therapy are regarded as some of the psychologist’s functions in this field. They do valuable work in the instruction of the staffs of institutions for adolescents and children, especially through group activities. Also they usefully undertake the management of parents; group discussions for remedial training.

Adults. In this field the psychologists undertake the intelligence, educational, vocational and projective testing, and they direct the junction with the occupational therapists. They can set out patients’ records in such a way that they will supply the needed data for statistical records. Similarly they can prepare and plan controlled psychiatric experiments in a way capable of statistical analysis.

Research. They carry out research into the various aspects of human behaviour and the best means by which patients, in all the psychiatric fields can be taught fully to use their abilities and skills.” (Dax, 1961, p.34)

As far as spiritual needs of his patients, and of the Australian population generally, Dax assumes that the Church can provide this:

“Chaplain’s functions within the hospitals relate to the patients’ spiritual needs and welfare and to their way of life, and therefore the duties of the chaplain may be defined as follows: 127

To see whether each patient admitted wants, or is likely to want, his spiritual help, and always to be available at a definite time for patients to visit him.

To arrange for prayers, services and religious observance for the patients of his own denomination.

To supervise the care of the hospital chapel.

To co-operate with the chaplains of the other denominations for the welfare of the patients.

To act as educational officer in the hospital and so to interest himself in such items as the library, debates, drama, English lessons, recreations, current affair discussions, choral societies, music, and the patients’ magazine.

To be available to see patients’ relatives and to communicate, as needs be, with their clergy.

To participate with the other medical associates in the treatment, resocialization and rehabilitation of the patients.

To further the understanding between the mental hospitals and the general public by interpreting the hospitals’ functions to the community” (Dax, 1961, p.35)

In other words, the mental hygiene movement seconded the Christian Churches, starting with the Anglican Church, as public relations agents for the treatments, diagnoses and propaganda provided by the psychiatric profession, which controlled the “mental hospitals”, despite the fact that what they were doing and teaching were the very antithesis of what Jesus of Nazareth did and taught. They also seconded the psychology profession, which competes with the psychiatry profession, to implement psychiatrist-designed treatment programs, administer psychiatrist-approved “intelligence tests” and “personality tests” for psychiatric diagnoses made by the psychiatrists (not the psychologists), and 128

process statistics which could be used by the medical and psychiatric profession, and, it turns out, the pharmaceutical industry.

The care of intellectually deficient children was already a self-appointed responsibility of the Christian Churches in Australia, and the conditions in which these children were kept from the earliest days of British colonization is a national disgrace. Although Dax does not write about mistreatment of psychiatric patients during his own years of office, his description of the conditions at the Kew Cottages in the 1950s gives some indication of how unwanted children were treated in Melbourne:

“There were open drains, children caught worms by drinking the water, there was little storage accomodation, the paint was drab and peeling. The children’s clothing was awful; the small boys had unlaced boots, long moleskin trousers turned up at the bottom, adult football jerseys which had been given to the cottages by a football club with old army jackets on top and whatever hats they could collect. They were dirty and had very little washing accomodation indeed. Many played in a shed during the day in a half-nude state, there was a battery of lavatories with eight or ten adjoining seats but there was no way of swilling the excreta out of the trough except by walking thirty yards for water. They passed urine into the open drains. The patients ate from tins with their fingers, slept on straw mattresses and the place smelt of stale food and excreta and unsatisfactory drainage.” (p.125)

Although there were improvements in the cosmetic appearance of many of the metropolitan institutions in the 1950s, 60s, 70s and 80s, the abusive treatment of young people in Australia, including forced labour, separation from families, and arbitrary punishment were to continue under the joint supervision of the Mental Hygiene/Health Authority (and its successors) and Church Organizations, later accompanied by bigger and bigger doses and combinations of crippling drugs. Dax explains:

“The intellectual deficiency colonies are partly under the care of the Mental Hygiene Authority and partly of several voluntary organizations. One of the latter is really a day-centre, organized 129

on a residential basis because it is in the middle of a sparsely populated district, where the pupils cannot come by transport each day, in other ways it is similar to the retarded children’s day-centres. There are eighteen boarders there who go home for holidays and frequently for weekends. A few day-children are taken. The other two voluntary residential colonies are run by the Catholic Church. Marillac House for retarded children from 6 to 16 was opened in 1943 by the Daughters of Charity of St Vincent de Paul. In 1961, there were ninety-six girls, of a higher intellectual level than the children in the retarded children’s centres and mostly of about special school standard.

“The Brothers of St John of God opened an institution in New South Wales in 1947 for the training of intellectually handicapped boys, and another in 1953 in Victoria. The children in the main training centre are at the special school level, but a lodge adjoining was later opened for those who were no more than the day-centre level. In 1957 they opened a farm colony and there are now 95 boys in the residential unit, and 40 in the farm colony.” (Dax, 1961, p.124)

The Church directly sold out to the corporate interests of the chemical industry and psychiatric profession by selling Churches for conversion into psychiatric treatment centres, where the treatments were inevitably chemicals, combined, at times, with surgical mutilation and electric shocks, physical restraint and solitary confinement, forced labour and brainwashing. Dax writes:

“The Clarendon Clinic [in East Melbourne] was formed by redesigning a church, its vestry, a church hall and an adjacent house. The body of the church has been converted into a therapeutic workshop and the vestry into four consulting rooms. The church hall has been made into a cloak-room, sitting- and dining-room, and a hall for the rooms, offices and staff rooms and a female toilet block.

“The clinic was designed to supply the needs of those patients who had been many years in hospital, had been rehabilitated there by the new methods used, and were now fit for community care. However many of them were unable to earn a living at first or to find accomodation except by the use, at least on a temporary basis, of one of the departmental 130

hostels. Moreover, many of them still needed some medical care, and were therefore followed up by their own medical staff who could visit the Clarendon Clinic to see them.”

The “new methods used” are inadequately described by Dax, but included insulin comas, chemical shock using cardiazol, injected and ingested tranquillisers, electric shocks (an older treatment) and brain mutilation by “psychosurgery”. He explains of the upgrading of “Larundel receiving house” into a major treatment centre, which it remains today:

“Larundel has a residential early-treatment unit and a short-term rehabilitation hospital attached. At Mont Park [the adjoining hospital] there is a longer term treatment hospital with a long-term rehabilitation hospital attached; this has a subdivision consisting of the general, medical and the surgical services and the neurosurgical unit, together with a geriatric hospital. Opposite to Larundel is a repatriation hospital for psychiatric cases attributable to war service. Within two miles is the old private hospital which is being used for geriatric patients but which may be converted later into a short-term alcoholism treatment centre” (Dax, 1961, p.177)

As they plotted to convert a general hospital for the elderly to an “alcoholism treatment centre”, the Mental Hygiene Authority and associated hospitals explored new treatments for their captives and converts with the aid of the then new “Mental Health Research Institute” in Parkville, Melbourne. Dax writes:

“In 1954 the Chief Clinical Officer, Dr Alan Stoller, was appointed, but much of his time in that year was spent in an Australia-wide survey of mental health needs and facilities, so he did not take up his position until 1955. Shortly after this the Mental Health Research Institute was built and officially opened by the late Sir Ian Clunies-Ross.

“In 1955 a Mental Health Research Fund was founded consisting of an annual grant by the Victorian government to the University of Melbourne…Within the first year the University 131

Department of Anatomy was able to demonstrate its work on the neuro-anatomical basis of emotion and growth on mongoloid children. The Departments of Physiology and Pharmacology were working on cerebral sedatives and analeptics while the Department of Pathology was doing research on cerebral arteriosclerosis.

“By the beginning of 1956 the Mental Health Research Institute was able to give demonstrations of the work proceeding in the Department on the incidence of schizophrenia, Huntington’s Chorea, juvenile delinquency, the clinical effects of tranquilizing drugs, electro- encephalographic studies of brain-damaged children and the results of infero-medial leucotomy [psychosurgery]. Studies had also been made on the treatment of excitement with lithium and its effects were being tried out at several hospitals.” (Dax, 1961, p.139)

The passage above reveals the connection between the mental hygiene movement, the University of Melbourne, the Mental Health Research Institute in Parkville and the public hospitals, including Royal Park Hospital, also in Parkville. In all these institutions the main focus was on drug treatments, although Dax was also enthusiastic about brain surgery for the treatment of psychological problems. At Royal Park Hospital, Larundel and other psychiatric hospitals electric shocks to the brain were also used for various conditions, the names of which have been changed over the past forty years. Electric shocks to the brain, usually called ECT in Australia, are used against people’s wishes in dozens of hospitals in Australia, today. The use of electrical shocks in Australia dates back to the 19th century, and it has been an unchanging feature of Australian psychiatry over the past century, although the “discovery” of ECT is usually attributed to Cerletti in Italy in the 1940s. Such is the nature of psychiatric diagnosis and treatment terminology as well as history: it is subject to frequent changes. Thus electric shocks to the brain have been called “electroconvulsive therapy” or ECT, “shock treatment”, “electroshock”, “electroplexy” and “electro-therapy”. The same class of drugs have been called “analeptics”, “neuroleptics”, “anti-psychotics”, “major tranquillisers” and “psychotropics”. The use of lithium was experimented with, in Dax’s terminology, for “excitement” (a suspect indication, indeed), but now it is used for “mania” and “bipolar affective disorder”. Previously “bipolar affective disorder” (BAD) was called “manic depression”. 132

Lithium was first used on psychiatric patients by the then 39 year old superintendent of Bundoora repatriation hospital in Victoria, Dr John Cade. This occurred in the 1940s, and since then the Victorian and Australian psychiatric hospitals have been avid dispensers of lithium, often referred to as a “mood stabiliser”. Although it may indeed prevent fluctuations in mood, the ingestion of lithium is accompanied by a range of unpleasant and dangerous side-effects and is extremely toxic in overdose. Lithium is toxic to the kidneys and thyroid in particular, and, since the toxicity margin is recognised to be low, regular blood tests to check lithium levels (also used to check compliance with drug-taking) are necessary if this drug is prescribed, as it often is done in Australia. It also dulls emotional reactions generally and produces a range of unpleasant mental side-effects in many who are forced to take the drug under threat of incarceration if they “fail to comply” with treatment.

The medical education system in Australia has, since its inception, like the military, been rigidly hierarchical, with professors at the top and medical students at the bottom, and the ladder is climbed by the acquisition of degrees and publications, together with less easily identified factors, which come into operation in the mysterious “upper echelons” of the academic world, an area where global politics plays a greater role than most people realise.

The Mental Health Research Institute in Parkville, Melbourne is Victoria’s biggest psychiatry research institution and is affiliated with the University of Melbourne, the city’s oldest university. The Institute was initially set up at Royal Park psychiatric hospital in the 1950s, shortly after, as was revealed in the press recently, several Nazi ‘scientists’ were smuggled into Melbourne.

The previous medical director of Royal Park Hospital, the psychiatrist Norman James, was, after the closure of Royal Park, appointed Chief Psychiatrist of Victoria by Victorian Premier Jeff Kennett, (a government appointment), replacing the Sri Lankan psychiatrist Carlyle Perera who held the position for many years. Norman James, a small bespectacled man in his 60s, is one of the most politically 133

powerful people in Australia, however, like other senior psychiatrists is hardly known outside the medical profession, police and judicial system. James wrote the opening chapter in the undergraduate textbook Foundations of Clinical Psychiatry (1994) titled “A Historical Context”.

In it he wrote:

“It was in the asylums that the first widely available and effective biological treatments were developed. Freud himself trained in neurology and recognised that the severely mentally ill required organic forms of treatment. The discovery of electroconvulsive therapy (ECT) by Cerletti and Bini who worked in a mental hospital in Rome in 1938 led to a simple and readily applied treatment for those who suffered from severe depressive illness and related disorders. Despite the advent of World War II, ECT was rapidly adopted as a treatment internationally.

“The discovery of lithium in 1949 as a treatment for mania and as a prophylaxis for bipolar disorder (manic depression) was made by Dr John Cade, a distinguished Australian Psychiatrist. This was soon followed by the development of major tranquillisers, the neuroleptics, by Delay and Deniker in Paris in 1952, although the initial idea of their application in psychiatry occurred in a general hospital when it was noted that they were effective tranquillisers for patients undergoing surgery. Shortly after this Nathan Kline made the discovery that a drug being tested for its effect in tuberculous patients had an antidepressant action and thus the first specific antidepressants were discovered, again in a large mental hospital and this time in Orangeburg, New York”.

Professor Edward Shorter, in A History of Psychiatry (1997) gives more details of John Cade’s less than exacting methodology in his rapturous description of the “medical discovery” of lithium:

“The story began in 1949 with John Cade, the 37-year-old superintendent of the Repatriation Mental Hospital in Bundoora, Australia [Victoria]. Cade, like Neil Macleod in late-nineteenth- 134

century Shanghai, had not lost his scientific curiosity despite his provincial isolation. He was determined to see if the cause of mania was some toxic product manufactured by the body itself, analogous to thyrotoxicosis from the thyroid. Not having any idea what, exactly, he might be searching for, he began taking urine from his manic patients and, in a disused hospital kitchen, injecting it into the bellies of guinea pigs. Sure enough, the guinea pigs died, as they did when injected with the urine of controls. Cade began investigating the various components of urine – urea, uric acid and so forth – and realized that to make urine soluble for purposes of injection he would have to mix it with lithium, an element that had been used medically since the nineteenth century (in the mistaken belief that it could serve as a solvent of uric acid in the treatment of gout).

“Then Cade, on a whim, tried injecting the guinea pigs with lithium alone, just to see what would happen. The guinea pigs became very lethargic. “Those who have experimented with guinea pigs”, he wrote, “know to what degree a ready startle reaction is part of their makeup. It was thus even more startling to the experimenter that after the injection of a solution of lithium carbonate they could be turned on their backs and that, instead of their usual frantic righting reflex behavior, they merely lay there and gazed placidly back at him.”

“Cade had stumbled into a discovery of staggering importance, yet he was able to develop it only because of his resoluteness in taking the next step. He decided to inject manic patients with lithium… he injected 10 of his manic patients, 6 schizophrenics, and 3 chronic psychotic depressives. The lithium produced no impact on the depressed patients; it calmed somewhat the restlessness of the schizophrenics. But its effect on the manic patients was flamboyant: All ten of them improved, though several discontinued the medication and were still in hospital at the time Cade wrote his article late in 1949. Five were discharged well, though on maintenance doses of lithium.” (p.256)

No mention is made in this book, or in Professor James’ account, of the toxicity and risks associated with swallowing (or injecting lithium), which are, in particular damage to the kidneys and thyroid. So dangerous is this drug, that regular blood tests must be done to guard against acute and chronic toxicity. 135

According to the MIMS Annual (1993), its “adverse reactions”, better described as “dangers and toxicity”, are briefly described as follows:

“Administration of lithium carbonate may precipitate goitre requiring treatment with thyroxine, but this regresses when treatment is discontinued. The ECG [electrocardiograph] may show flattening of the T wave. Hypercalcaemia, hypermagnesaemia, weight gain and oedema may occur, and skin conditions may be aggravated. The toxic symptoms are referable to the gastrointestinal tract and the central nervous system. These must be known by the patient and his or her nurses and relatives. Those referable to the gastrointestinal tract are anorexia, nausea, vomiting, severe abdominal discomfort and diarrhoea. Those referable to the central nervous system are lassitude, ataxia, slurred speech, tremor (marked) and agitation. If none of these are present, the patient is not intoxicated. Patients suffering from lithium toxicity look sick, pale, grey, drawn and asthenic. It is vital to bear in mind that lithium can be fatal, if prescribed or ingested in excess…At serum lithium levels above 2 to 3 mmol/L, increasing disorientation and loss of consciousness may be followed by seizures, coma and death.”

Heralding the “discovery” of lithium by Cade by a Victorian psychiatrist as a great moment in medical science, the Victorian medical establishment, including Professor Norman James, has long been insistent on the treatment of “manic” and even “hypomanic” people with lithium. This is despite the known risks and toxicity of the drug.

Lithium is said, by Australian psychiatrists, to “stabilise the mood”, and it is assumed that people who have had even brief episodes of “elevation” or “abnormal excitement” need long term mood stabilization with the drug. This includes single episodes of “hypomania”, which is described in the American Psychiatric Association’s DSM IV as follows:

“A Hypomanic Episode is defined as a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood that lasts for at least 4 days (Criterion A). 136

This period of abnormal mood must be accompanied by at least three additional symptoms from a list that includes inflated self-esteem or grandiosity (nondelusional), decreased need for sleep, pressure of speech, flight of ideas, distractibility, increased involvement in goal-directed activities or psychomotor retardation, and excessive involvement in pleasurable activities that have a high potential for painful consequences (Criterion B)”. (p.335)

As if it makes the diagnostic criteria “precise” and “specific”, the DSM adds that:

“If the mood is irritable rather than elevated or expansive [which are not further defined in the DSM IV], at least four of the above symptoms must be present.”

It is incredible that “increased goal directed activities” and “non-delusional increase in self-esteem” could be cited as evidence of mental illhealth rather than an indication of improved health. Furthermore DSM IV adds that:

“The change in functioning for some individuals may take the form of a marked increase in efficiency, accomplishments or creativity.” (p.335)

It is strange that this mental state should be viewed as an “abnormal” one, but at least the American Psychiatric Association (unlike the Australian psychiatric establishment) does not advocate incarceration or forced drugging for “hypomania”. The reference manual says:

“In contrast to a Manic Episode, a Hypomanic Episode is not severe enough to cause marked impairment in social or occupational functioning or to require hospitalization, and there are no psychotic features.” 137

The University of Melbourne’s Foundations of Clinical Psychiatry is not as clear in their distinction between “hypomania” and “mania” and “hypomania” has only two references to it, one relating to diagnosis and one relating to treatment. Under “Abnormal states of mood elevation” is written:

“Far less commonly [than depression], a persistent elevated mood occurs. Similarly, a continuum of severity if found with the mild states difficult to distinguish from normality. Moderate severity Hypomania, or severe state Mania, are obvious, the patient’s behaviour having serious consequences if treatment is not swiftly initiated. Most manic patients also experience depressive swings, and this condition is therefore referred to as Bipolar Mood Disorder.” (p129)

The recommended treatment is described under “management of elevated mood states”:

“The assessment and treatment of the patient suffering from acute hypomania or mania is essentially the management of the acutely psychotic patient. Organic conditions, including drug-induced states, need to be excluded. For reasons of safety, most patients need hospitalisation which, because of the lack of insight, may need to be recommended. The mainstay of pharmacotherapy are the neuroleptics, such as Haloperidol or Chlorpromazine. Although lithium carbonate is an effective antimanic agent at relatively high concentrations risks of toxicity discourage its use. Occasionally, for particularly severe cases, ECT is needed.” (p.144)

The drugs recommended for the treatment of “hypomania” and “mania” turn out to be the same ones recommended for “schizophrenia” and “ECT” is electroconvulsive treatment (shock treatment), which is used for “depression” as well as its “opposite”, “mania” and also for severe or “intractable” psychosis (including that supposedly due to “schizophrenia” or “schizoaffective disorder”). Unlike 138

many other parts of the world, where ECT has been banned or seriously restricted, in Australia the use of electrical shocks has increased in recent years and is used more widely (in more centres and for more reasons). Most of the psychiatric hospitals in Australian cities give patients ECT, often against their will.

Involuntary ECT in the State of Victoria is said to be restricted to “emergency cases”, but it is left to the individual psychiatrist to define what constitutes an “emergency”. The systems of appeal open to the protesting patient are very limited. They can appeal to the Chief Psychiatrist, Norman James, who has the authority to stop the abusive use of drugs or ECT. It is most unlikely that he would, however. James, who was previously head of psychiatry at the Royal Park Hospital is a keen advocate of both ECT and the use of “neuroleptic drugs”. It is he who wrote the opening chapter of Foundations of Clinical Psychiatry. In it, he wrote an intriguing passage:

“The asylums inaugurated as a result of humanistic urges soon became grossly overcrowded, despite the fact that some were among the largest and most expensive buildings erected by the governments of the day. Numerous difficulties beset them. As a result of their isolation they became large, impersonal, human warehouses. Patients had few if any rights and were completely at the mercy of their carer – a largely untrained workforce from which has arisen the modern profession of psychiatric nursing. There was a total lack of any specific physical treatment for mental illness until the advent of ECT [so much for walking in gardens, music and warm baths]. Those who did improve did so largely by the passage of time and the happy advent of a spontaneous remission [not ‘recovery’]. These conditions led to a cycle of scandals, public inquiries, usually some temporary improvement and then a relapse into previous conditions or worse.” (p.9)

It could be time for another public inquiry.

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In psychiatric wards and Mental Health Review Board hearings the psychiatric patient is judged guilty unless proven innocent. Unfortunately innocence (of ‘mental illness’ or ‘personality disorder’) cannot actually be proved according to prevailing psychiatric theory which does not view humans in terms of “guilty” or “innocent”. All psychiatric patients are “officially innocent”, just “unfortunately inflicted with an (invisible) illness”. One which “unfortunately tends to run in families”. Thus entire families are stigmatised without laying blame on any individual. It is not the fault of the family or the individual to be afflicted with illness: it is “just one of those things”. Maybe genetics plays a role. That way individuals in the family can scan their relatives (and in-laws) for evidence of insanity.

As for the diagnosed patient, regardless of whether he or she is called a “mental patient”, “schizophrenic”, “nutcase”, “client” or “consumer” there is no escape from the judgement of “defective” and the accompanying stigma. Even if no evidence can be found at a particular time of mental illness, the patient can be accused of “masking” (hiding) their madness or be in remission.

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BRITISH PREJUDICES IN ITS COLONIES

The English colonists who decided on Australia as an ideal site for a penal colony were not unprejudiced men, as their own records and transcripts of their speeches demonstrate. In 1779, when Joseph Banks recommended Botany Bay as a site for a convict colony, he is recorded in the Journals of the House of Commons as suggesting:

“In case it should be thought expedient to establish a Colony of convicted Felons in any distant Part of the Globe, from whence their Escape might be difficult, and where, from the Fertility of the Soil, they might be enabled to maintain themselves, after the First Year, with little or no Aid from the Mother Country, to give his Opinion what Place would be most eligible for such Settlement? informed your Committee, That the Place which appeared to him best adapted for such a Purpose, was Botany Bay, on the Coast of New Holland, in the Indian Ocean, which was about Seven Months Voyage from England; that he apprehended there would be little Probability of any Opposition from the Natives, as, during his Stay there, in the year 1770, he saw very few, and did not think there were above Fifty in all the Neighbourhood, and had Reason to believe the Country was very thinly peopled ; those he saw were naked, treacherous, and armed with Lances, but extremely cowardly, and constantly retired from our People when they made the least Appearance of Resistance…” (p.61, Sources of Australian History, Manning C. Clark, 1957)

The British plan to make Australia into a penal colony was based on several factors about the large island previously known as New Holland, after the “discovery” of the island continent by Dutch sailors and merchants in the 1600s. The main reasons that Australia was chosen were that it was “far away” and “relatively unpopulated”. The extraordinary beauty of the land was largely unappreciated by the European colonists whose primary motive was “exploitation of resources”, including both “natural resources” and “human resources”, but, until the discovery of gold in Victoria and New South Wales in the 1850s and subsequently extensive mineral deposits in many other areas, Australia was considered a 141

useless piece of land by all the Europeans nations that visited. This included the Dutch, Spanish, French and English and probably also the Portuguese, Chinese and Indians, all of whom explored the area now called Indonesia prior to the 1800s. As the early historical records show, another important motive by the English for colonizing Australia was to prevent their arch-enemies, the French, from taking possession of the continent.

As the historian Manning C Clark explains:

“External causes also contributed to the occupation of more territory. Fear of the French, a chronic mental disease of the English over the whole period, led to the abortive settlements at Western Port (Victoria) in 1826, and to a military settlement using convict labour at King George’s Sound (Western Australia) in the same year. The prospect of capturing some of the trade with Indonesia led to the creation of a convict settlement at Port Essington in 1826. Fear of the French played a part, too, in the decision to create a new colony on the Swan River …” (p.143)

In World History of Psychiatry Professor Dax, who presided over the “reforms in mental health care” in the state of Victoria that occurred in the 1950s and 1960s only hints at the abusive treatment of early psychiatric inmates in Australia:

“There is little record of any special treatment other than the usual purging, bleeding, blisters, and setons. The electrical machine at Lachlan Park in Tasmania has already been noted, and an ominous sounding “acid to the spine”…”

The “electrical machine” Professor Dax refers to was a torture device, to which immobilised lunatics would be strapped down and electrocuted for upto half an hour daily (p.709). This cruel piece of what 142

was then very modern technology was used as early as 1851 according to records from the Lachlan Park ‘hospital’ in Tasmania, which was then administered by the Commonwealth of Britain as a prison colony.

Britain had, at the time, a horrible history regarding institutional treatment of those deemed “insane” by the medical profession and other authorities. Bethlem Hospital, the first ‘modern asylum’, was renovated in 1676, and was considered one of the finest buildings in London, resembling the “Tuilleries”, a French royal palace, from the outside. This was a consequence of petty rivalry between the King of England and the King of France, and Louis XIV of France was said to have been displeased with what he saw as a deliberate slight against himself and the “French Empire”. As it turned out, though, George III, the “mad” King of England, who reigned when Britain “lost America” and “claimed Australia” was himself treated by the medical experts of the time, who for some reason thought that he was even madder than other members of the British aristocracy. King George III was subject to bleeding, blistering, scarifying, purging, emetics and solitary confinement when he went “mad” recurrently during his reign, concluding with a final “breakdown” at the age of 82, according to Professor John Howells who wrote the chapter on “Great Britain” in the same book.

Howells elaborates on the “less harsh treatment” given to inmates of British asylums in the late 1700s and early 1800s:

“Regulations provided for periodical inspections of chained patients, to make sure that the circulation of the blood was not impeded. Blood-letting was the usual remedy for manic patients, who were also calmed with warm baths, tartar emetic, and purgatives; melancholic patients were given similar treatment, but they were immersed in cold water. Sores were artificially produced, as it was believed that they provided an outlet for “bad humours”.(p.192)

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Despite the high ideals professed by the carers of the mentally ill in England, a public scandal resulting in a Parliamentary Enquiry occurred when in 1814, a Mr William Norris who was suffering from tuberculosis (which used to be called “consumption”) was discovered in a dark damp cell in Bethlem, having been kept there in chains for 10 years. He died a year after being removed from the place, but Professor Howells, who recounts the story in World History of Psychiatry does not explain how, exactly, he died. It is not unreasonable to wonder, given the “public scandal” surrounding his case, whether the doctors who supervised his “treatment” in Bethlem had anything to do with his treatment after he left the ‘hospital’.

Bethlem Hospital, from which the word “bedlam” is derived, was acquired by the City of London in 1547 and remained a city-run asylum until 1948, although it also housed private patients, some of whom were young women whom Dr John Haslam, the physician of Bethlem in 1809, lamented had been subject to a brutal operation termed “spouting”. The torturous mutilation, which included removal of the front teeth of upper and lower jaw was intended to “let the madness out through the mouth”, since, at the time, madness and mental derangement were still thought to be caused by “bad humours”.

Later in the eighteenth and nineteenth centuries it was also believed that madness was caused by abnormalities of blood flow to the brain, a theory favoured by American psychiatrists such as Benjamin Rush and others. This was used to rationalise the practice of bleeding and other “physical treatments”, which were used on people who were physically bound, chained and imprisoned. Flogging was a common punishment, and other treatments, following the industrial revolution, included technological wizardry such as spinning chairs and beds, and Rush’s own “Tranquilliser Chair” which prevented all movement and vision.

British psychiatry, which developed during the era of official British slavery and imperialism has been punitive from the outset. It has also been characterised by double standards based on class and race. 144

What was shrugged off as “eccentricity” in the “upper classes” was punished as insanity in the “lower classes”, later called the “working classes”. The ruling aristocracy and monarchy (royal family), after whom several Australian and British hospitals are still named were allowed to behave in ways and believe things which were not tolerated in “commoners” as they referred to their “subjects”. In Australia today, several people (mainly men) remain incarcerated indefinitely in “forensic psychiatry hospitals” without having been found guilty of any crime. These people, who have been deemed “criminally insane” are held “at her Majesty’s pleasure”. Queen Elizabeth of England has, of course, never met any of the people who are imprisoned for life “at her pleasure”.

The treatments given to psychiatric patients in Australian Hospitals and asylums closely followed those in England in important respects, but the level of experimentation with cruel new treatments in Australia exceeded that of the “mother country” of Australian psychiatry. Because most of the biggest hospitals and universities in Australia were built using British advice, British designs and British systems of hierarchy, administration and organization, the political and cultural links between Australian medicine (including psychiatry) have always been deep, although in recent years there has been an increasing influence from American psychiatry in the style of the APA, whose DSM is accepted as an authoritative source by Australian courts and public hospital psychiatrists.

Unlike American psychiatry, which was strongly influenced by Freudian psychoanalysis, Australian and British psychiatrists have traditionally been more focused and often exclusively focused on drug treatments and “physical treatments” (such as electric shocks, chemical shocks and brain mutilation). The drugs used in Australia and Britain are largely the same, and prescribed for the same ‘diagnoses’, although the doses used in Australia are usually higher, and they are often prescribed in combinations, with some patients receiving three, four or five drugs at the same time. Many of the large drug and chemical companies in Australia, including SmithKline Beecham and Imperial Chemical Industries (ICI) are based in England. Likewise many mining companies.

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This is a pattern repeated in other ‘Commonwealth’ countries including Canada, South Africa and New Zealand, in which universities and hospitals were also built during the reign of the British Empire. These countries were the “white colonies”, but universities and hospitals, administered initially by white colonists, were also built in other British colonies, which are now considered to be part of the “Third World”. These include India, Sri Lanka, Singapore, Hong Kong, Fiji, Rhodesia (now Zimbabwe and Zambia), Ghana (in Western Africa, previously called the ‘Gold Coast’), Kenya (in East Africa) and several islands in the Caribbean Sea (the West Indies). During the colonial era, a “divide and rule” policy was employed by the British, where minority elites were established to rule over the majority population through a British-controlled public service and colonial administration. This strategy has had disastrous effects in nations around the world, resulting in prolonged civil wars in many countries after they were “granted independence” in the tumultuous years following the Second World War.

The universities founded by the British taught British-style psychiatry, complete with “schizophrenia”, “manic-depression” and “personality disorders” as well as the drugs favoured for their treatment. British psychiatry was itself strongly influenced by Western European psychiatry, especially that of the professors in German, Austrian and Swiss universities. Then and now, universities were closely associated with hospitals and asylums which treated the poor and disadvantaged. In these hospitals, in which young doctors were trained and old doctors established empires, various “therapeutic interventions” were attempted to cure or control the mad, some more cruel than others.

The focus of treatment of the insane has always been on control of behaviour, rather than cure of psychological distress and the diagnoses favoured were also based on outward evidence of “abnormal behaviour” rather than the more subtle attempts by European and particularly Jewish European doctors (including Freud) to understand the intricacies of the human mind through “psychoanalysis”. Psychoanalysis, which was largely based on Freud’s prejudiced and confused ideas about sexuality became very popular in the United States of America after the Second World War, but never gained a foothold in the more “conservative” British universities and hospitals. The same was and remains the case in Australia: psychoanalysis and also psychotherapy based on words (“talk therapies”) are 146

generally thought as “ineffective in the management of serious mental illness” in line with a similar belief prevalent amongst British psychiatrists.

The connection between British and Australian psychiatry (and other medical “specialties”) is more than a historical one. Today the entire system of “medical qualification” and “specialist recognition” as well as most of the postgraduate (and much of the undergraduate) medical education is controlled by the so-called “Royal Colleges”. These shadowy remnants of British Imperialism (and possibly Freemasonry) were instituted during the age of slavery and were centred in London, and the old British Universities: the Universities of London, Oxford and Cambridge. These institutions were initially the only ones which could confer “academic qualifications” in the British Empire, including “degrees”, “fellowships” and “professorial positions”.

In the British academic hierarchy, which was exported to the colonies and instituted in colonial universities, the heads of each department or faculty were called “professor” and they had authority over the more “junior academic staff”. This junior staff included tutors and lecturers, who were graded as “junior lecturers” and “senior lecturers”. It took many years to climb the academic hierarchy, which was (and is) centred in the universities. This “academic ladder” could be climbed in several ways, but was largely available only for those born into privileged families (and who went to the ‘right schools’). One way to climb the ladder was simply by staying in the same institution, and waiting one’s “turn” to be professor. It could be a long and futile wait. Professorial positions were few, and jealously guarded. The Royal Colleges, dominated by old men from private schools and with “good connections” had control over “professional qualifications” generally, and this included who could call themselves “professor”. This hierarchy was instituted in all the fields of science, as well as in the “arts”.

The British tertiary education system divided all knowledge into “science” or “arts”. Politics, history and philosophy became faculties of the arts, while medicine, surgery, geology, biology and astronomy 147

were considered, along with some other disciplines, to constitute the “sciences”. Progress in the lower grades of the academic hierarchy could only be by passing tests and examinations devised, controlled and judged by “senior academic staff”, most of whom were, and still are, male.

The medical sciences were, in the British and European academic systems, fundamentally divided into “medicine” and “surgery” the politics of which were controlled by the London-based “Royal College of Physicians” and “Royal College of Surgeons”. In Australia, these became the “Royal Australasian College of Physicians” (RACP) and the “Royal Australasian College of Surgeons” (RACS). These patriarchal, authoritarian bodies confer “higher qualifications” (“post-graduate” qualifications) to medical graduates who continue in “training positions” within the public hospital system. Senior members of these colleges were (and are) made, according to changing and inconsistent rules, into “fellows” of the college, who were “more highly qualified” than “ordinary members” or “unspecialised doctors”. They were allowed, according to the rules of academia, to write FRCP or FRCS after their names and call themselves “physicians” or “surgeons”.

Over the past one hundred years, new Australian colleges have been founded based on a similar model and with intricate political connections with the older colleges. These include the Royal Australian College of General Practitioners (RACGP) and the Royal Australian and New Zealand College of Psychiatry (RANZCP). They too confer fellowships according to obscure and secretive rules and rites of passage. These are not democratic organizations. Old boys are given “honorary degrees” for doing favours for other old boys (or the Royal tradition). This is a world still dominated by old school ties. It is rigidly hierarchical, authoritarian and patriarchal. Women who are allowed to climb to the professorial top of the academic ladder are obliged to accept misogynist traditions and behaviour from the middle-aged men who control all these colleges.

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The diagnostic model favoured by British psychiatrists who taught in the teaching hospitals and universities in England and Australia was developed initially by German and Swiss “lunatic” asylum psychiatrists such as Professors Emil Kraepelin and Eugen Bleuler, who described, for the first time, so-called “organic mental illnesses” such as “manic depression” and “schizophrenia”. Developed in a background of Protestant Christianity, the ideas and views which were held to be “irrational”, “bizarre”, “odd”, “grandiose” and in other ways indicative of “psychosis” and “mental illness” were based on a fundamentally Judao-Christian paradigm. It was thus considered indicative of mental abnormality if one had unconventional beliefs concerning “God”, “good and evil”, “Satan”, “the Devil”, “angels”, “saints”, “messiahs”, “spirits”, “reincarnation” or “possession”. These “delusional beliefs” included any of many “personal experiences” with the divine or “supernatural”, which were included in the psychiatric symptom of “religiosity”, indicative of “schizophrenia” and “mania”. Serious mental illness would also be suspected in young people who suddenly changed their religious and/or political beliefs. A “conversion” to Buddhism, Hinduism or Islam, an embracing of Indigenous American or “Shamanic” religions were all to be suspected, and words were developed to describe the core beliefs of non-Christian religious beliefs as “schizophrenic”. This is reflected today in the World Health Organization’s “Brief Psychiatric Rating Scale” (BPRS) which suggests that “unusual thoughts” can be elicited by asking, “Do you have a special relationship with God?” The BPRS explains that delusions are to be suspected on the basis of “preoccupation” with “unusual beliefs in psychic powers, spirits, UFOs or unrealistic beliefs in one’s own abilities”. “New Age” ideas can also be diagnosed as “schizophrenic”.

The treatment for these conditions was (and is) forced treatment in a “secure” environment. “Secure” environments have provision for treatment in locked rooms, solitary confinement and physical restraint while the “treatment” (usually initially in the form of ‘tranquillising’ injections) is commenced. The diagnosis is one for life. A “schizophrenic’ can never be healed – he or she can only “go into remission”. In other words further episodes of madness and chronic mental deterioration are likely. Ironically the “seeing of visions”, “hearing of God’s voice”, “visitations by angels” and “battles with demons” which feature so prominently in the Christian Bible all became evidence of “mental derangement” in the fundamentally atheistic blend of Psychiatry, Capitalism and Protestant Christian moralism which evolved over the twentieth century and was implemented in “mental hygeine programs” throughout the Commonwealth. 149

This “Protestant Christian psychiatry” involved the Anglican Church in fundamental ways in Australia as well as England. The Church determined what were “orthodox” and “conventional” thus “acceptable” and “normal” interpretations of the Bible and Theology, as well as being directly involved in the “rehabilitation” of mental patients and the care of the “chronically ill”. A belief that one was possessed by “evil spirits” or “Satan” was treated with chemical or electrical shocks at first, and later by injections and tablets of dopamine-blockers. A belief that one “heard the voice of God”, “communicated with angels (or extra-terrestrials)” or was “the (or a) messiah” was treated the same way. A refusal to renounce the “delusional” (heretical) belief was diagnosed as “chronic mental illness” and refusal to accept such an interpretation of one’s religious beliefs was called “lack of insight”. The same criteria for diagnosis and the same treatments (with minor variations) have been employed in both Australian and British psychiatric hospitals. Australian psychiatry has also come under an increasing influence, however, from the American Psychiatric Association (APA) over the past fifty years.

In every Australian university and psychiatric hospital will be found at least one copy of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), now into its fourth edition which was published, with much fanfare, in 1994. The seal of the American Psychiatric Association portrays the “American Father of Psychiatry”, Benjamin Rush, the most famous American physician of his time (and place) and a highly placed officer in George Washington’s military forces during the American War of Independence (1776-1783). Rush, who was the only doctor to sign the Declaration of Independence, was a keen proponent of bloodletting, in line with his theory that all mental illness is caused by derangement of blood flow in the brain. He also developed other methods of torture including the “gyrator chair” as well as the “tranquilliser chair”. Flogging, too, was employed in Rush’s hospitals, not regarded as punishment, but for “therapeutic” reasons.

Rush had another theory that is not mentioned in the DSM or other current psychiatric texts, which are generally omissive regarding historical detail, especially about the more unpleasant aspects of the past, as far as psychiatric treatment and theory are concerned. Rush’s theory regarding “black” people was that they are affected by a disease (“negritude”) which causes both their “abnormal skin color” as well 150

as their “abnormal behavior and beliefs”. This was inline with his avid support of slavery of Africans by “naturally superior” white people.

The acknowledgement of Rush as the official “Father of Psychiatry” followed an actual formal declaration by the American Psychiatric Association, in 1965, according to the Canadian historian Professor Edward Shorter who admits that the venerated “physician” was more a propagandist than a promoter of health. In A History of Psychiatry (1997) Shorter writes:

“Rush’s partisans have argued that his occasional musings on moral suasion anticipated later psychological therapies. Yet, psychological sensitivity is difficult to detect in his practice. As one visitor to the Pennsylvania Hospital in 1787 recounted of Rush’s rounds, “we next took a view of the maniacs. Their cells are about 10 feet square, and made as strong as a prison…In each door is a hole, large enough to give them food etc., which is closed with a little door secured with strong bolts.” Most of the patients were lying on straw. “Some of them were extremely fierce and raving, nearly or quite naked.”…”

Rush, however claimed differently when he wrote his textbook, published in 1812, lying that his patients, “now taste the blessings of air, and light, and motion, in pleasant shaded walks in summer…have recovered the human figure, and with it, their long forgotten relationship to their friends and the public” (Shorter,1997). The father of American psychiatry had a “scientific” theory that rationalised his practice of bleeding patients until their “overactivity” decreased, and their “mad ravings” were quietened (as happens with acute blood loss, prior to loss of consciousness and death if the blood loss continues). This was his bizarrely reductionist and simplistic theory that “the cause of madness is seated primarily in the blood-vessels of the brain, and it depends upon the same kind of morbid and irregular actions that continues other arterial diseases” (Shorter, 1997). In truth, however, this is no more stupid than the numerous equally simplistic explanations of madness (including “chemical imbalance” theories) that have followed his reductionist line of thinking. 151

Bizarre mechanistic models of the body, brain and mind have existed in many areas of medicine, but the most grotesque, prejudiced and outrageous ideas have originated in the minds of psychiatrists and psychoanalysts, whose destructive theoretical assumptions are shared, although the two schools of thought have been at odds with each other regarding the place of drug therapy versus “psychoanalytical psychotherapy” for the treatment of mental disorders. The shared assumptions (with notable dissidents) are that mental illness is “underdiagnosed” and thus “undertreated” and that serious mental illness is incurable and “very difficult to treat”. This is predictable since it is they who get paid for the diagnosis and treatment of “sick” individuals, as well as for advice and teaching about how “mentally ill people” should be treated in the future. Euphemistically the mechanistic drug promoters in modern psychiatry are referred to in the psychiatric literature as “biological psychiatrists” and their chemical-oriented eugenics theories are referred to as “biological psychiatry”.

Professor Shorter, professor of the History of Medicine in Toronto, Canada, describes the false paradox that has him confused:

“Psychiatry has always been torn between two visions of mental illness. One vision stresses the neurosciences, with their interest in brain chemistry, brain anatomy, and medication, seeing the origin of psychic distress in the biology of the cerebral cortex. The other vision stresses the psychosocial side of patients’ lives, attributing their symptoms to social problems or past personal stresses to which people may adjust imperfectly…The neuroscience version is usually called biological psychiatry; the social stress version makes great virtue of the “biopsychosocial” model of illness. Yet even though psychiatrists may share both perspectives, when it comes to treating individual patients, the perspectives themselves really are polar opposites, in that both cannot be true at the same time. Either one’s depression is due to a biologically influenced imbalance in one’s neurotransmitters, perhaps activated by stress, or it stems from some psychodynamic process in one’s unconscious mind. It is thus of great importance which vision has the upper hand within psychiatry at any given moment.” (p.27)

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Shorter is confused in believing that “biological psychiatry” and the “bio-psycho-social model” (of which there are many) have irreconcilable differences. They are, in fact, in their present form, closely related. The recognition that “stress” can cause mental illness and that “psychosocial factors” influence both stress and mental illness are obvious. The focus on “stress” and “mental illness” or on “neurotransmitters” is not conducive, however to the promotion of mental health. Genuine scientific biology is also a far cry from “biological psychiatry” which shares more common ground with “biological warfare” than the objective, logical study of living things.

Biological warfare and military medicine (including military psychiatry) are intrinsically related. Both thrive on the preparation for and existence of warfare. Furthermore, the diagnostic criteria in the DSM were originally designed to screen candidates for military conscription. During the Second World War, when there was massive expansion of the propaganda industry and the chemical industry, the objective of the military psychiatrists was to train soldiers, and return “shell-shocked” soldiers to the frontline. To do this they used brainwashing techniques, drugs and electric shocks.

This was the case for all sides of the war. The American psychiatrists taught patriotism to America, capitalism, the Constitution and the “Founding Fathers”, the British psychiatrists programmed their patients with “patriotism for the Empire”, “love of King and Country” and “hatred of the enemy”. During the Second World War, “the enemy” included Germans (whose psychiatrists trained soldiers to fight for the “Fatherland”), Italians (likewise, but for the Fascists), Japanese, Communists and “traitors” (those who would not support the “war effort”).

Owing to the subservience of the Australian political, military, medical and social systems to the “old country” the “war effort” and war propaganda in and from Britain produced jingoistic war fever combined with “patriotism” not for Australia (and her very different needs) but for England, Britain and the British Empire. The medical profession, Red Cross and Church leaders all contributed to 153

creating and maintaining this war fever. While Nazi doctors were engineering and implementing eugenic theories with death camps, gas chambers and “medical experiments” on unwilling subjects, the Allies instituted “internment camps” for Germans, Italians and Japanese unfortunate enough to be living in Australia at the time, and “gas chambers” (they were actually termed as such) in Northern Queensland to test the effects of mustard gas on young Australian volunteers from the army. These young people, who were sworn to secrecy and told they were helping the “war effort”, discovered that mustard gas causes horrific burns and permanent health problems following even brief exposure. At the same time, Jewish refugees, interred Italians and wounded Australian soldiers were deliberately infected with malaria (also in Northern Queensland) to test anti-malarial drugs, also ostensibly for the “war effort”. Of shame to this “charity”, the Red Cross was directly involved in the malaria experiments, providing the infected blood for transfusion into the victims.

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MENTAL PATIENT RIGHTS IN AUSTRALIA

Each State in Australia has different mental health laws, which is one of the confusing things about human rights in Australia. In Victoria the current Mental Health Act was passed in 1986, with significant, but largely unnoticed amendments in 1995, which greatly expanded the criteria for which people could be incarcerated and forcibly treated in this State. The changes were centred on subtle changes to the wording of the act including the addition of the term “mental disorder” to include the term “mental illness” in the 1986 Act.

The reason for the addition of the term mental disorder was claimed, at the time, to provide for the forced treatment of a small number of “self-mutilating” people who, suffering from what is psychiatrically termed a “personality disorder” rather than a “mental illness” are excluded from forced treatment under the existing law. However events in the psychiatric literature at the time and since suggest far greater possibilities for application of this new reason for involuntary treatment. One is “Attention Deficit/Hyperactivity Disorder”, another is “Conduct Disorder” and yet another, “Oppositional Defiant Disorder”, all new “mental disorders” announced in the 1994 edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM IV).

The American Psychiatric Association is not a democratic organization, nor has it a history of supporting freedom, independence, human rights or friendship. The head on the emblem of the APA seal is that of the white supremacist and medical charlatan Benjamin Rush, who is regarded by the APA as “the founding father of American Psychiatry”. In addition to a legendary obsession with self- promotion, Rush had theories that “black skin is caused by disease” and “all mental illness is caused by abnormality in blood vessels of the brain”. Based on his simplistic theory, Rush advocated “blood letting” as the treatment necessary for a range of “mental illnesses” and also devised or implemented several torture devises such as spinning chairs and beds, immobilization chairs and other cruel 155

punishments and then justified their use with scientific-sounding reasons. None of this is mentioned in the DSM IV, which does not mention Rush other than the words “Benjamin Rush 1844” under the portrait of this infamous man.

The DSM does, however have a brief section titled “Historical Background”, which gives some indication of the perspective the organization would like to give of itself and psychiatry:

“The need for a classification of mental disorders has been clear throughout the history of medicine, but there has been little agreement on which disorders should be included and the optimal method for their organization. The many nomenclatures that have been developed during the past two millennia have differed in their relative emphasis on phenomenology, etiology and course as defining features. Some systems have included only a handful of diagnostic categories; others have included thousands. Moreover, the various systems for categorizing mental disorders have differed with respect to whether their principle objective was for use in clinical, research, or statistical settings. Because the history of classification is too extensive to be summarized here, we focus briefly only on those aspects that have led directly to the development of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and to the “Mental Disorders” sections in the various editions of the International Classification of Diseases (ICD).

“In the United States, the initial impetus for developing a classification of mental disorders was the need to collect statistical information. What might be considered the first official attempt to gather information about mental illness in the United States was the recording of the frequency of one category – “idiocy/insanity” in the 1840 census. By the 1880 census, seven categories of mental illness were distinguished – mania, melancholia, monomania, paresis, dementia, dipsomania, and epilepsy. In 1917, the Committee on Statistics of the American Psychiatric Association (at that time called the American Medico-Psychological Association [the name was changed in 1921]), together with the National Commission on Mental Hygeine, formulated a plan that was adopted by the Bureau of the Census for gathering uniform statistics across mental hospitals. Although this system devoted more attention to clinical utility than did 156

previous systems, it was still primarily a statistical classification. The American Psychiatric Association subsequently collaborated with the New York Academy of Medicine to develop a nationally acceptable psychiatric nomenclature that would be incorporated within the first edition of the American Medical Association’s Standard Classified Nomenclature of Disease. This nomenclature was designed primarily for diagnosing inpatients with severe psychiatric and neurological disorders.

“A much broader nomenclature was later developed by the U.S. Army (and modified by the Veterans Administration) in order to better incorporate the outpatient presentations of World War II servicemen and veterans (e.g., psychophysiological, personality, and acute disorders). Contemporaneously, the World Health Organization (WHO) published the sixth edition of ICD, which, for the first time, included a section for mental disorders. ICD-6 was heavily influenced by the Veterans Administration nomenclature and included 10 categories for psychoses, 9 for psychoneuroses, and 7 for disorders of character, behavior, and intelligence.” (p.xvii)

It is evident, then that the military (defence forces) have always been closely involved in the development and application of psychiatric labels and ‘physical’ treatments of ‘nervous disorders’. This involvement is more sinister than most would imagine, and has caused more distress to the public than would initially appear possible. This distress has been caused by much more than misapplied labels of “Post Traumatic Stress Disorder” (a label directly adapted from the old label of ‘shell-shock’). The ‘militarisation’ of the USA and Australia have resulted in panic, depression, suicide, psychosis and drug addiction in these nations, as it is bound to in any nations that promote terror and horror on television screens at the same time as handing out addictive tranquillisers in hospitals and clinics to “calm the nerves” and giving free reign to alcohol merchants to use all the tricks of modern technology and advertising in “developing new markets”. When one also realises how closely militarisation is associated with privatization, “globalization” and establishment of a white-controlled “New World Order”, more of the disaster that has befallen modern society might be recognised.

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EUGENICS AND ‘MENTAL HYGEINE’

It may be worth briefly reviewing the eugenic doctrines that shaped Australian psychiatry in the 20th century. Eugenics is a scientific theory concerned with “breeding better human beings”, and consists of “positive eugenics” (encouraging people with selected gene pools to have more children) and “negative eugenics”(preventing the breeding of ‘undesirables’). The theory was directly developed by blood relatives of the English aristocrat and evolutionist Charles Robert Darwin. These were Darwin’s cousin Francis Galton and his son Leonard Darwin, who founded the first “society for eugenics” in the 1880s, not long after the official abolition of slavery in the United States of America. The Englishmen who developed a human racial hierarchy for the implementation of their genocidal plans placed themselves, their families and friends at the top of the list of favoured blood lines, and attempted, by various means to prove their genetic superiority over the majority of the human population. Galton considered himself to belong to a family “well-endowed with geniuses”, which included himself and his cousin Charles Darwin, who was Britain’s most famous scientist, by the time Galton founded the first Society for Eugenics, shortly after writing Hereditary Genius in 1869. In it he hypothesised that mental qualities are biologically inherited, that “the white race” is biologically shaped to dominate and that, among the “white race”, the English are the most superior.

Darwin himself argued in Descent of Man (1871) that:

“The variability or diversity of the mental faculties in men of the same race, not to mention the greater differences between the men of distinct races, is so notorious that not a word need here be said.

“So in regard to mental qualities, their transmission is manifest in our dogs, horses, and other domestic animals. Besides special tastes and habits, general intelligence, courage, bad and good temper &c., are certainly transmitted. With man we see similar facts in almost every family; and we now know, through the admirable labours of Mr.Galton, that genius…tends to be 158

inherited; and, on the other hand, it is too certain that insanity, and deteriorated mental powers likewise run in families.”

Darwin (1809-1882), who had travelled as a scientific observer on the HMS Beagle in the 1850s, developed the theory of evolution of species by natural selection following detailed observation of animal species (birds, in particular) and, to the outrage of biblical creationists, presented evidence that man was descended from apes in Descent of Man. Although he himself was parodied in cartoons at the time as being part-ape, his followers seriously embarked on a scientific quest to discover which races were “closest to apes”, and which were “the most evolved” with several false assumptions already clouding their judgement.

Murray and Wells wrote, in From Sand, Swamp and Heath:

“From the mid-1800s the evolutionary theories of Darwin and the geological principles of Sir Charles Lyell began to take hold of European thinking. Darwin’s ideas were applied to the Australian native, and reduced him to the embodiment of primeval man. Thomas Huxley drew comparisons between the Aboriginal skull and that of Neanderthal man and Schoetensack even suggested that man originated in Australia. By 1900 the Aborigine was regarded as a simple, habitual being, incapable of adapting to change.” (p.83)

Racism inherent in supposedly “anthropological” analysis of the indigenous people of Australia has been repeated in numerous ways over the past 150 years, ranging from scientific papers and texts to school atlases. From the 1940s publication for Australian schoolchildren by the Adelaide Advertiser, The Modern Pictorial World Atlas, is the following description of “The Stone-Age Men of Australia”: 159

“Australia, it has been remarked, is the asylum of many quaint creatures, like the duck-billed platypus, who have ages since disappeared from the rest of the world. It is also the home of one of the most primitive of human peoples – the Aborigines, the Stone-Age men in the twentieth century.

“They live in the arid, semi-desert lands of Central Australia. With increasing white penetration of their inhospitable bush, their numbers have rapidly dwindled. In thirty years at the beginning of the century the Arunta tribe diminished from about 2000 to about three to four hundred souls.

“Their skins are of a dark chocolate colour, but well smeared with ochre and decorated with coloured designs. They are, on the whole, a little shorter than the average white Australian, but fairly well built, and they carry themselves with a graceful, erect carriage. Through work and child-bearing, the women grow old and hideously ugly by the time they are thirty.

“Very early man probably had a face resembling that of the Australian aborigine in his heavy, overhanging brows and receding forehead.” (p.78)

An obsession in skull size and shapes which apparently indicated mental attributes was a particular feature of the nineteenth century scientific racists, who developed pseudosciences named “craniometry” and “phrenology” to prove such things as the inferiority of blacks, the criminality of ‘half-breeds’ and the mental weakness of women. The famous neurologist Paul Broca, a keen craniometrist, asserted:

“In general, the brain is larger in men than in women, in eminent men than in men of mediocre talent, in superior races than in inferior races. Other things equal, there is a remarkable relationship between the development of intelligence and the volume of the brain.”

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Steven Jay Gould, the popular scientific writer and evolutionary biologist from Harvard University, from whose 1983 collection of essays titled The Panda’s Thumb the above quote is borrowed, points out the biases that were demonstrated in the efforts of craniometrists to prove their own superiority:

“In an outrageous example of data selected to conform with a priori prejudice, he [E.A.Spitzka, an American craniometrist] arranged, in order, a large brain from an eminent white male, a bushwoman from Africa, and a gorilla. (He could easily have reversed the first two by choosing a larger black and a smaller white.) Spitzka concluded, again invoking the shade of Georges Cuvier: “The jump from a Cuvier or a Thackeray to a Zulu or a Bushman is no greater than from the latter to the gorilla or the orang.”

“Such overt racism is no longer common among scientists, and I trust that no one would now try to rank races or sexes by the average size of their brains. Yet our fascination with the physical basis of intelligence persists (as it should), and the naïve hope remains in some quarters that size or some other unambiguous external feature might capture the subtlety within. Indeed, the crassest form of more-is-better – using an easily measured quantity to assess improperly a far more subtle and easily measured quality – is still with us…This essay was inspired by recent reports on the whereabouts of Einstein’s brain. Yes, Einstein’s brain was removed for study, but a quarter century after his death, the results have not been published. The remaining pieces – others were farmed out to various specialists – now rest in a Mason jar packed in a cardboard box marked “Costa Cider” and housed in an office in Wichita, Kansas. Nothing has been published because nothing unusual has been found. “So far it’s fallen within normal limits for his age,” remarked the owner of the Mason jar.” (p.125-6)

The craniometrists used as their yardstick for big-headed, white geniuses the skull of the French biologist Baron Georges Cuvier, who died in 1832. Gould writes, with characteristic wit:

“Cuvier’s contemporaries marveled at his “massive head.” One admirer affirmed that it “gave to his entire person an undeniable cachet of majesty and to his face an expression of profound meditation.” Thus, when Cuvier died, his colleagues, in the interests of science and curiosity, 161

decided to open the great skull. On Tuesday, May 15, 1832, at seven o’clock in the morning, a group of the greatest doctors and biologists of France gathered to dissect the body of Georges Cuvier. They began with the internal organs and, finding “nothing very remarkable,” switched their attention to Cuvier’s skull. “Thus,” wrote the physician in charge, “we were about to contemplate the instrument of this powerful intelligence.” And their expectations were rewarded. The brain of Georges Cuvier weighed 1,830 grams, more than 400 grams above average and 200 grams larger than any non-diseased brain previously weighed.” (p.122)

These attempts at proving the superiority of white men occurred prior to Darwin’s theories, but with the acceptance that men were related to apes additional prejudices became apparent as the efforts to prove which race was superior gathered momentum. They reached new depths with the development of eugenic theories which recommended the sterilization and later, the mass-murder, of “defective” and “degenerate” individuals and races, amongst which were the previously enslaved Africans, as well as Jews and Gypsies (another much maligned and persecuted people). The Nazi regime in Germany and Europe also murdered communists, political dissidents, deformed and disabled children and adults, and “mentally ill” people in their misguided efforts to create a “pure, white Aryan super-race”.

Unknown to many in the modern world, however, the eugenic theories and policies which gave rise to the genocide of the 1940s were not an isolated aberration of Nazi madmen. The theories, which originated in England, not Germany, were the predominant socio-medico-anthropological beliefs in Europe, North America, Australia, New Zealand and South Africa of the time, and had been for many decades. The first eugenic sterilization laws, legislating for the castration of “feeble-minded” boys were enacted in the United States in the early 1900s, and centres for eugenic study and policy development were established in association with major universities in Melbourne, Sydney, Brisbane and other Australian universities, which shared ideas and attitudes with American, British and Canadian Universities, including those at Oxford and Cambridge. In the 1920s large amounts of money were spent by the Carnegie foundation and other American eugenics supporters to develop the philosophy in what was still intended to be a “White Australia”. 162

A similar corporate support for white supremacy eugenics in psychiatry and the medical sciences is evident from the historical account of South African Psychiatry in A World History of Psychiatry as described by Professor Lewis Hurst, professor of psychological medicine at Johannesburg, although he does not describe it as such:

“In 1926 the number of mental defectives in South Africa was estimated at 300,000. When in 1927 the president of the Carnegie Corporation visited South Africa, the Dutch Reformed Church requested his assistance in investigating the matter. The Carnegie Corporation gave substantial financial assistance and provided the services of C.W.Coulter and K.L.Butterfield to assist in research.” (p.616)

This quote is taken from the pro-psychiatry World History of Psychiatry, which was published in 1975, when the racist apartheid regime continued white rule in South Africa. The injustices of racial segregation and denial of civil rights to the African and “coloured” population of South Africa are not considered important enough to mention in the professor’s account of psychiatry, but they are evident in the limited statistics presented of “patients accomodation” in “institutions for mental defectives”. Two, named as those at Alexandra and Umgeni Waterfall contained only “whites”: treating 879 and 445 patients respectively. Some contained both “whites” and “non-whites”, including institutions at Komani (1,498 patients), Oranje (1,636), Valkenberg (1,911) and Weskoppies (2,122). The largest institution (or most crowded) contained only “non-white” inmates, one at Bophelong, the “patient accomodation” of which is listed as 2,500.

What does not become clear from Professor Hurst’s account of psychiatry in South Africa is what constituted “mental defectiveness” and what type of treatment was given to the people thus diagnosed. It is easy to deduce these things, however, by examining psychiatric trends and treatments in other nations that have come under the influence of the eugenics movement, white supremacy movement and 163

“Mental Hygiene Movement”, including Australia and New Zealand. Hurst refers to this movement under the subtitle “National Societies”:

“Passing reference has already been made to the role played by the National Society for the Care of the Feebleminded in the case of mental defect or subnormality. The mental health movement originated in the United States, and came out of the experience of Clifford Beers. As a result of his endeavors in this direction, the National Committee for Mental Hygiene of the United States came into being on February 19, 1909, followed by the creation of local bodies in various cities, a pattern followed in South Africa and many other countries” (p.618)

Clifford Beers was an ex-psychiatric patient who wrote an influential book describing his illness, hospitalisation and recovery titled A Mind that Found Itself in 1908, following which he was involved in the foundation of the National Committee for Mental Hygeine, together with the American psychiatrists Adolf Meyer and William James. While the mental hygiene movement urged some reforms in the treatment of the inmates of psychiatric hospitals, based on Beers’ experiences which were “degrading and unpleasant in the extreme”, their main agenda was an expansion of psychiatric and eugenic influence and policies into the wider community. In this matter, accounts of various historians differ. The psychiatric apologist Professor Edward Shorter writes, in his 1997 book, A History of Psychiatry:

“Psychiatry further reached out with the founding in 1909 of the National Committee for Mental Hygiene. A book by ex-psychiatric patient Clifford Beers, A Mind That Found Itself (published in 1908), prompted a number of prominent figures such as Meyer and William James to promote the concept of “mental hygiene”. In subsequent years, the mental hygiene movement involved psychiatrists in numerous plans to improve the “mental health” of Americans through various well-meaning efforts.” (p.161)

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Bruce Wiseman, in Psychiatry, the Ultimate Betrayal (1995), presents a different view, and provides more detail to support it:

“The genesis of the Mental Hygiene movement is usually told as follows: In 1908, Clifford Beers, a former mental patient, wrote the sordid story of his incarceration in a book entitled A Mind That Found Itself. The book was so well received that Beers went on to found the National Committee for Mental Hygiene, an organization formed to assist the cause of the mentally disturbed as well as promote the prevention of mental illness.

“But there is more to the story. Before Beers published the book, he sent the manuscript to the Father of American Psychology, William James. James endorsed it wholeheartedly. And, armed with William James’ support, he went to talk to psychiatrists, neurologists, social workers and social-minded laymen.

“In September, 1907, he took the manuscript to well-known psychiatrist Adolf Meyer. A member of the Eugenics Society, Meyer had been a student of Alfred Hoche, co-author of The Release of the Destruction of Life Devoid of Value, the book promoting the killing of mental defectives. He also studied under Swiss psychiatrist August Forel, “whose influence on the young student was great,” according to one biographer. An example of Forel’s views: “Even for their own good the blacks must be treated as what they are, an absolutely subordinate, inferior, lower type of men, incapable themselves of culture.” (p.71)

In customary fashion, the medical apologist historians accounts omit any reference to racist theories by eminent psychiatrists. Michael Stone, Professor of Psychiatry at the Columbia College of Physicians and Surgeons, writes of Forel, in Healing the Mind (1998):

“Swiss physician August Forel had been influenced by the Nancy hypnotists, Liebault and Bernheim, as had Krafft-Ebing and Freud. Forel (1905) wrote on the topic of female sexuality, including themes popular at the time, such as that of femme fatale and the “flirt”. He also addressed the general topics of sadism, masochism, exhibitionism, fetishism, and 165

homosexuality in men and women. Turning toward forensic matters, his 1905 Die Sexuelle Frage [The Sexual Question] included case histories of mothers who had strangled their babies.” (p.146)

Edward Shorter has yet another perspective of Forel:

“A more dyed-in-the-wool organicist than August Forel, Zurich psychiatry professor between 1879 and 1898, would be hard to imagine. Forel spent much of his time doing neuroanatomy, and his correspondence with colleagues reflects far greater interest in frog brains than in clinical psychiatry. Yet Forel was a master hypnotist. So great was his reputation that one colleague referred to him a woman whom another hypnotist had put into an evil hypnotic trance, with the request that Forel lift the trance. Later in life, Forel even went beyond hypnotism to talk of “love” and “intimate knowledge” of patients’ lives. Thus for Forel, there was no contradiction between a neuroscientific view of psychiatry and psychotherapy.” (p.139)

When describing Adolf Meyer in glowing terms, Shorter fails to mention his views on race either; likewise Stone, who describes the once president of the American Psychiatry Association thus:

“Adolf Meyer (1866-1950) exerted enormous influence on psychiatry in America, not just in the 1920s, though this decade offers a convenient time frame to discuss his work. Like Jung, he was the son of a Swiss pastor. He studied under August Forel in Zurich, then worked in France with Dejerine, and later in England, where he was impressed with the work of Hughlings- Jackson, from whom he derived his ideas about the layers of brain organization and the organism’s adaptation to the environment.

“Meyer came to the United States in 1893, working first as a neurologist. His interest in psychopathology was stimulated by William James. He established a friendship with another prominent psychologist, John Dewey. In 1907 Meyer met Clifford Beers and, joining hands 166

with this former mental patient, now reformer of hospitals, started a mental-hygiene movement in America. Meyer also had an illustrious teaching career; he taught at New York State Psychiatric Institute, later at John Hopkins and the Henry Phipps Psychiatric Clinic, both in Baltimore. In 1927 he was president of the American Psychiatric Association” (p.153)

Bruce Wiseman provides more of the picture:

“In 1909, the National Committee for Mental Hygiene was formed, with Beers as its head. Adolf Meyer and William James were among the original twelve charter members.

“James’ role was not small. In a biography by Clarence Karier we are told: “James was not only a theoretical conceptualizer of the therapeutic society but also an active historical actor, helping to shape its development. Late in life (1909), as an executive committee member of the National Committee for Mental Hygiene, he wrote to John D. Rockefeller and ‘begged’ him for a million dollars to support the efforts of the National Committee for Mental Hygiene…Shortly thereafter, the foundations under Rockefeller’s influence began to pour millions of dollars into the mental hygiene movement, into the development and construction of psychopathic hospitals, and into the training of psychiatrists, psychologists, and mental health workers in a variety of institutions across the country”…The Mental Hygiene movement expanded rapidly around the globe, setting up groups in the 1920s in Canada, France, Belgium, England, Bulgaria, Denmark, Hungary, Czechoslovakia, Italy, Russia, Germany, Austria, Switzerland, and Australia. Twenty-four countries had Mental Hygiene Associations by 1930.” (p74)

According to Raymond Fosdick’s The Story of the Rockfeller Foundation (1952) the Rockefellers were centrally involved in this expansion of ‘global’ Mental Hygeine Associations:

“In 1913, shortly after its creation, the Foundation began a co-operative relationship with the National Committee for Mental Hygeine, and for many years supported its activities and 167

studies of the institutional treatment of mental diseases. It was during the early part of this period that Dr.Thomas W. Salmon was engaged by the Foundation as its adviser in matters relating to mental hygeine, his services being placed at the disposal of the National Committee. Under this arrangement the work continued to expand, with emphasis increasingly on the problem of the individual. Out of Dr.Salmon’s recommendation that all criminals sentenced to state prisons should first be sent to psychiatric clinics for classification [labelling] grew the clinic established at Sing Sing in 1916, the first of its kind in America.

“Dr. Salmon resigned from the Foundation in 1921 to take the professorship of psychiatry at Columbia University, but the Foundation’s contributions to the general expenses of the National Committee for Mental Hygeine and for its successor organization, the National Mental Health Foundation, have continued up to the present time. During this period, the Laura Spelman Rockefeller Memorial became interested in psychiatry and in the related subjects of child psychology and industrial psychology, both in Canada and the United States. The most ambitious undertaking of the Memorial in this field led to the creation of the Institute of Human Relations at Yale. Over the years, the various Rockefeller boards contributed very substantial sums to this Institute, and while even a broad definition of psychiatry would not cover all that was done there, the major part of the support was for use in this field.

“The activities which the Foundation began in 1933, however, were launched on a far more comprehensive scale. Officially, the programme in psychiatry was initiated by a report made by Dr. David L. Edsall, Dean of the Harvard Medical School, who was also a trustee of the Foundation.” (p.146-7)

At the same time, the Rockefeller Foundation funded numerous eugenics programs in the USA and Europe (as well as Australia and South Africa). Fosdick writes:

“But the classical field which has received the largest measure of support is genetics [eugenics]. An accounting in 1950 showed that assistance had been given to fify-three universities and other institutions, and the training of forty-six geneticists [eugenists] had been 168

aided directly through National Research fellowships. Altogether, up to that time, approximately two and three-quarter million dollars had been contributed to genetics research through the National Sciences Division…In England, Foundation grants have supported projects in mathematical genetics at London University and the University of Birmingham. In France, aid has gone to the genetics laboratory of the Rothschild Foundation at Paris and the recently established French Institute of Genetics at Gif. But, to a greater extent than in any other biological science, the bulk of the appropriations for genetics went to American research workers. The research-team idea has found its finest embodiment in the United States, and the Foundation is proud to have been a co-worker with such groups as the Muller-Sonneborn- Cleland trimvirate at Indiana University, the Dunn-Dobzhansky group at Columbia, and the Morgan-Sturtevant-Beadle succession at the California Institute of Technology.” (p.183)

Professors Dunn and Dobzhansky’s views on eugenics are described in an earlier chapter. Professor Sturtevant of the California Institute of Technology was quoted regarding his opinions on genetic damage to subsequent generations from nuclear fallout and X-rays, which was contained in the 1958 Allen and Unwin publication Frontiers of Science, in which the esteemed Charles Robert Darwin’s less esteemed grandson, the physicist Sir Charles Galton Darwin called for a “tremendous” solution to the “problem of overpopulation” that was more brutal than war, and more murderous than nuclear bombs. George W.Beadle, Chairman of the Biology Division of the California Institute of Technology (Caltech) since 1946, was Professor of Biology at Stanford University during the Second World War a noted expert in the bread mould Neurospora. Professor Beadle authored the introduction to the “Biological Sciences” section of Frontiers of Science, in which he gave a typically eugenist perspective of “the mind”:

“The Mind. Through knowledge of science man is capable of freeing himself of the limitations of mutation and natural selection in his future evolution. Achievement of this freedom will not be easy. It will require wisdom, courage, and faith far beyond anything man has so far displayed. 169

“All this is possible because of the mind. What is the mind and how does it work? We are only beginning to make progress in this enormously complex and difficult field. The most elaborate computing machine that can be imagined is nothing beside the mind of man. The mind can invent the machine, but the machine can do only what the information fed into it orders. And the mind of man must formulate the information and must tell the machine what to do with it.

“Through a series of ingenious and delicate experiments on the brains of fish, frogs, salamanders, rats, cats, and monkeys, Professor Roger Sperry and Doctor John Stamm give us a tiny glimpse of what the psychobiologist of the future might be able to learn about this mind which makes man unique among all living things and can give him mastery of himself, the world, and all the vast space that lies beyond.

“Cultural inheritance is not separable from biological inheritance. The first cannot exist without the second. It follows that, while man is nurturing his cultural inheritance, he must not let his biological inheritance regress [what Saleeby called ‘dysgenics’]. And this it will surely do if care is not taken. Relaxation of natural selection, or natural selection for the wrong characteristics, can lead to a degeneration of the biological capacity for continued cultural inheritance.” (p.16)

Roger Sperry, who had previously held a “joint appointment at the University of Chicago and the National Institutes of Health at Bethesda, Maryland” before his appointment at Caltech in 1954, was a pioneer in animal and human “split brain experiments”. His ‘ingenious and delicate experiments’ on the brains of animals are described in his chapter in Frontiers of Science on ‘Brain Mechanisms in Behavior”. These included connecting the cutting the nerves from the eyes of frogs (optic nerves) and connecting them to opposite sides of the brain (“under these conditions, the animals respond thereafter as if everything is seen through one eye were being viewed through the opposite eye”), and cutting out various parts of the brain of animals (cats, monkeys) to study their effects on behaviour. 170

Sperry was the first to perform split-brain experiments in humans, ostensibly as a possible cure for epilepsy, but equally out of scientific curiosity. This is evident from his comments on split-brain experiments in 1958 (he did most of his human experiments in the 1960s):

“It has been somewhat embarrassing to our concepts of brain organization that complete surgical section of this largest fiber tract [the corpus callosum, the tract of white matter connecting the left and right hemispheres of the brain] has consistently failed in human patients to produce any clear-cut functional symptoms. In checking this observation in animal experiments, however, we have been able in recent years to demonstrate definite integrative functions for this structure.

“In these experiments, carried out mainly in cats, we first section all crossed optic fibres at the chiasma, in order to restrict the input from each eye to the same side of the brain. The animal is then taught a few simple visual discriminations with a mask covering one eye. After the habit has been stabilized by overtraining, the mask is shifted to the other eye…Without the callosum, such animals apparently have no recollection with one eye of what they have been doing with the other eye.” (p.57)

A primary technique used by Sperry was comparisons of the effect of brain mutilation between different species. Writing of split-brain experiments on monkeys, which preceded his more extensive work on human ‘epileptics’, the famous neuroscientist continues:

“At the present time we are investigating the functional capacities of small islands of cerebral cortex. In these studies we put to use the above-mentioned functional independence of the two hemispheres in what we have come to call the ‘split-brain preparation.’ This is an animal in which the brain has been split down the middle by sectioning the corpus callosum, hippocampal commissure [part of the limbic system], and the optic chiasma and, frequently also, some of the lower-level connecting systems. To casual examination, these split-brain animals after recovery are indistinguishable from normal in their general cage behavior.” (p.59) 171

It is not “normal” for animals to live in a cage; thus their ‘general cage behaviour’ is already on of an imprisoned, suffering animal. Comparing animals with different degrees of brain mutilation ‘prepares the ground’ for similar experiments on humans – and indeed these were being done at the same time, most notoriously by the “ice-pick lobotomist” Walter Freeman.

Melbourne’s psychiatry reformer, Eric Cunningham Dax was also a proponent of lobotomies for ‘difficult patients’ during the 1950s and 1960s, at the time Walter Freeman was touring the “Western world” conducting lobotomies (over 100,000 such operations were apparently done during this time). Asylum to Community is Professor Eric Cunningham Dax’s version of “the development of the mental hygiene service in Victoria, Australia”, over which he presided, after he emigrated from England in 1952, as head of the Mental Hygiene Authority (later called Mental Health Authority). The book was published in 1961 by F.W Cheshire “for the world federation for mental health”. Despite the fact that the book was written during the days of the official White Australia Policy, or perhaps because of it, aborigines and the treatment or even the existence of Aboriginal people in Australia is not mentioned at all. The focus of the book is on new hospitals and clinics which were built with public support (following newspaper support) of reforms for the care of the mentally afflicted white residents and immigrants (some of whom were not strictly speaking ‘white-skinned’), describing in detail training programs and construction programs, as well as details of administration and the complex network of institutions involved in the reform of the mental health services which occurred after the Second World War in the State of Victoria.

These institutions are listed in the appendix as “clinics”, “hostels”, “social clubs”, “day hospitals”, “early-treatment hospitals”, “mental rehabilitation hospitals”, “intellectual deficiency services” and “other clinics”. The focus is on ‘early diagnosis and treatment’, although cure of “mental illness” is considered beyond the possibility of even “successful treatment”, which remains poorly defined throughout the book. It appears on close examination of the book that the types of treatment instituted 172

in the network of “psychiatric hospitals” and “clinics” would be difficult to recover from, especially the “surgical treatments” like “leucotomy” when areas of the brain were deliberately destroyed in the hope of “improving behaviour”. Only one institution is listed in the appendix under “other clinics”: Pentridge Prison. The Mental Hygeine Authority took over the medical staffing of Melbourne’s main jail in 1959. Under the subtitle “sociopaths”, Dax writes:

“For many years the country prisons at Beechworth and Ballarat have been supplied with medical care by the staff of the local mental hospitals. Previously the Chief Government Medical Officer and his assistant looked after Pentridge (which is the male prison in Melbourne) though when a new psychiatric clinic was opened there in 1959, the Mental Hygiene Department undertook the medical staffing of this unit and also of the prison.” (p.133)

He continues to explain how closely the psychiatric system is involved with the courts and prisons systems, painting a rosy picture of the prisoners’ liberties in what he admits are “rather grim surroundings”:

“…most of them are occupied with industrial work, and there is some individual therapy there and a most interesting programme of psycho-drama. The patients organize their entertainments and have an active library and education section. Group therapy is highly organized and most productive. This same medical staff looks after the Alexandra Parade Clinic, since the sociopaths at Pentridge and the alcoholics overlap appreciably. When patients are remanded on bond by the courts for medical examination the reports are made at the Alexandra Parade Clinic, when they are remanded in custody the reports are made at Pentridge. Sociopaths who have spent a short time in the prison psychiatric unit may be in need of more treatment when they are discharged, and they will then attend the Alexandra Parade Clinic to see their doctors. For this reason the staff of the clinic work in close conjunction with the probation officers and one of these officers regularly attends the Alexandra Parade Clinic and sees patients there when they have their appointments for psychiatric treatment.” (p.133)

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Although he does not explain treatment in other than the most vague ways in the text, a few comments do give an indication of what was being offered to the Australian people in the way of health promotion. In his final chapter, titled “the future”, Dax writes:

“Within the past forty years vast strides have been taken, in two eras of psychiatric treatment. First the physical treatments were used, malaria for general paralysis [syphilis], prolonged sleep, insulin comas, cardiazol and electroplexy, leucotomy, abreaction, and the use of barbiturates. Next the advent of social psychiatry, industrial occupation, group activities and therapies, rehabilitation, resocialization and the tranquilizing drugs brought in a new phase of treatment.

“Now we are on the edge of a more fundamental change. Even in our lifetime we shall see psychiatry move into the community and a new attitude emerge to mental illness, its prevention and its treatment. Perhaps this is the most exciting phase of all, for with support, tolerance and group understanding we may together learn to carry more of the stresses of civilization within our new community structure.” (p.205)

Dax does not mention the word ‘eugenics’ in his book, nor admit to the connection between the eugenics movement and the mental hygeine movement, but he does include in another appendix a list of drugs being “studied” under the auspices of the Mental Hygeine Authority, some of which are still used today, but all of which can cause acute toxicity and chronic illness themselves. These drugs include Chlorpromazine (Largactil), Reserpine, Melleril, Tofranil, Stelazine, Librium, Parnate, Bromides and Mono-amine oxidases. Chlorpromazine, Melleril and Stelazine are crippling dopamine- blocking “major tranquillisers” notorious for causing tardive dyskinesia and other forms of chronic brain and nervous system damage. These and other toxic chemicals, including lithium and benzodiazepines (the first of which was Librium) have been forced into people of all races and ages in Australia via the public hospitals and community psychiatric services, over the past fifty years, and especially in the past five.

174

Dax is best known in Melbourne, to which he returned from Tasmania in 1984, for the “Cunningham Dax Collection of Psychiatric Art” which includes over 6,000 works of art by (often imprisoned) psychiatric patients and is administered by the Mental Health Research Institute at Parkville. The collection is used as a means to teach high school and university students in Melbourne how to diagnose mental illness from people’s art. Professor Dax began this collection, he told me last year, in 1947, when he was working as a psychiatrist in Surrey, England, and continued to build a large collection in Victoria since the 1950s, after he emigrated to Australia (largely by acquiring the art of inmates of the Royal Park Hospital, several of whom are now dead, unlike Dr Cunningham Dax). The ownership of the 80 or so paintings he first appropriated was disputed by the British hospitals he had taken them from, and he says, he “took 80 pictures back to France” in 1952, and “assumed” they had “gone back to the hospitals”. Dax is now 91 years old, and refused to comment on problems in local or international psychiatry, saying his “views were out of date”. He said he still goes in, twice a week, to keep an eye on “his” collection.

Is the collection really his, though? He certainly collected them, but the majority of the people who did the art were prisoners of the system he headed, and are not even personally acknowledged for their often amazing work. They become “schizophrenics”, “manic depressives” and “psychotics”. Their art becomes evidence of “mental illness” demonstrating “psychopathology” rather than creative genius. Their art was taken without payment or recognition, and they were able to produce brilliant works of art despite forced treatment which robbed them of their freedom, dignity and physical health. They were truly “tortured artists”.

This tradition of forced slave labour in the guise of “occupational therapy” has a long history in the “mental health system”, and still, every year, the Mental Health System and allied organizations pathologise creative activity by young people in Australia, while collecting their art, for free. One of the most influential of these organizations, which often masquerade as “independent non-government organizations (NGOs)”, is the “Mental Health Foundation”. 175

ORGANISED SELLING OF MADNESS

According to the self promotional literature of the Mental Health Foundation of 1997, the Foundation was established “in 1930 as the Victorian Association for Mental Hygiene”, however, the next year, they were claiming something different:

“The Foundation was established in 1981 by a group of mental health & business entrepreneurs in response to awareness that governments could not permanently fund voluntary organisations.”

The chairman of the Mental Health Foundation is Professor Graham Burrows, who heads a Board of Directors which, according to their promotional literature, has a “National Scientific Advisory Board” which “comprises key resource people and leaders in mental health opinion & policy development around Australia” and a “National Organisation” which “comprises organisations, individual & corporate members throughout Australia”. The 1998 pamphlet continues with the claim that “these include consumers and carers with experience of mental illness; members attracted by the mental health promotion & education programmes, professionals attracted by the Partnership programs; and, others are the corporate supporters & sponsors.” These “corporate sponsors” include drug companies, and the Mental Health Foundation avidly supports drug treatment for a wide range of “mental illnesses”, and have provided a plethora of “mental health education” literature which promote both mental illness diagnoses and drugs to treat them. This is despite claims that the aims of the Foundation are to “raise funds to promote mental health & wellbeing, public involvement in mental health, removal of the stigma linked with mental illness, research on mental health issues, effective prevention programmes and mental health education”.

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An example of “mental health education” by the Foundation is witnessed in a pamphlet titled “Break down the barriers of mental illness”, sponsored by Eli Lilly, manufacturers and promoters of the SSRI antidepressant Prozac. It begins with a most contentious claim:

“One person in four in Australia right now is suffering a mental health problem or mental illness severe enough to significantly affect their daily lives.”

What, exactly, these “mental health problems” and “mental illnesses” are, is not explained in the pamphlet, which is vague about this, in the extreme:

“These can range from long term, but intermittent severe illnesses, to short term stress related disorders.

“Mental health problems and illness affect people from all cultural backgrounds in rural and remote areas as well as the cities.

“All are treatable, and with care and treatment, people usually do recover.

“After recovery, people with a mental illness usually want to continue to live their lives as they did prior to their illness, as we all expect following a physical illness – to return to work or school, to have fun, to care for, and be loved by friends, while continuing to receive treatment and medication for their illnesses.

“Yet anyone who experiences a mental health problem or illness will suffer, in addition to their illness, the pain caused by stigma and its related discrimination and isolation.”

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The irony that the psychiatric profession should be exhorting the public to be aware of “stigma” whilst actively creating prejudice, drug addiction, social isolation and suicide clearly escapes the authors of the pamphlet. The extent of discrimination (including governmental discrimination) against people who have been diagnosed with “serious mental illnesses” such as “schizophrenia” and “bipolar affective disorder” is listed in the pamphlet:

• It is harder to get and keep work

• Some government legislation discriminates against the mentally ill

• It is harder to join sporting and recreation groups

• Exclusion from membership of Boards of community associations or companies

• Insurance companies often refuse to insure mentally ill people or raise premiums for superannuation, health cover, travel and life insurances, amongst others

• Some travel companies and airlines may refuse to carry people experiencing a mental illness

• People with a mental illness who may look or act strangely or possibly cry in the street, shopping centres, public transport are avoided or ignored instead of being comforted by others

• Children whose parents have a mental illness find their friends at school may drift away or ostracise them

• There is even a popular misconception that people with a mental illness have a developmental disability rather than an illness”

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This perspective on “stigma” is far from the reality of psychiatric survivors in Australia and it fails to explain the genuine causes of stigma and prejudice against people who have been tortured as “psychiatric patients”, euphemistically referred to, in recent mental health propaganda, as “consumers”.

The injections of dopamine-blocking “anti-psychotics” that people deemed to be “seriously mentally ill” are routinely subjected to themselves cause the appearance to “strangeness”. They cause a distressing range of movement disorders, including akathesia (difficulty staying still and an urge to pace), Parkinsonism (tremor, rigidity and slowed movements) and tardive dyskinesia (involuntary spasms and grimaces of the face and limbs).

Combined with the social isolation that results from weeks, months or years of imprisonment, paranoia instilled in family members and friends regarding “a relapse of mental illness”, media demonisation of “psychopaths” and systematic disinformation connecting mental illness with drug addiction and violence, people who have been treated for mental illness in the Australian public hospital psychiatric system can claim to have survived chemical and psychological torture.

The Mental Health Foundation, however, claims that “this stigma and isolation is caused by myth and misunderstanding of mental illness”. In claiming to be dispelling such myths, the Foundation reinforces the view that drug compliance is of paramount importance in the treatment of mental illness, and denies the extensive human rights abuses occurring in Australian hospitals and psychiatric treatment clinics and centres. The Foundation described its “directly supported projects” as:

• Stress Management Programs for corporate, community & rural sectors

• National Depression Awareness Campaign 179

• Towards a Gentler Society Campaign (TAGS)

• Quiet Crisis Campaign

• Partnership Programme for GP’s & Pharmacists

• Mental Health Lecture Series

• OPTIONS (Schools) addressing bullying

• OPTIONS (Community) addressing suicide

• Multimedia Information & Resources Project

• Mood Disorders Group

• G-LINE Problem Gambling Service

The Foundation claims that it “enjoys a reputation built on its success in collaboration, support, auspice & sponsorship”, and that others “to benefit” include the “Addiction Research Institute”, “Association of Relatives & Friends of the Mentally Ill”, “Alzheimers Diseases & Related Disorders Society”, “Anorexia & Bulimia Nervosa Education Campaign”, “Children’s Protection Week”, “Obsessive Compulsive Disorder Foundation” and “States’ Mental Health Foundations”. The Mental Health Foundation claims to “enjoy collaborative and support alliances with many national, state and international agencies” including:

• Addiction Research Institute

• Alzheimer’s Association Australia 180

• Australian Medical Association

• Australian National Association for Mental Health

• Australian Red Cross

• Australian Federation of Deaf Societies

• Australian Society of Hypnosis

• Council on Aging (Australia)

• East-West Centre on Mental Health

• Family Services Australia

• Federation of Australian Jewish Welfare Societies

• National Council of YMCA Australia

• National Mental Health Council

• Pharmaceutical Society of Australia

• Royal Australian New Zealand College of Psychiatrists

• Royal Australian College of General Practitioners

• Many Church Social Justice Committees

• American Psychiatric Association 181

• International Society of Hypnosis

• International Society for Stress

• World Federation for Mental Health

• World Psychiatric Association

The gold-embossed pamphlet, does not admit to an author, however, the activities of the Mental Health Foundation are controlled by Professor Graham Burrows, Director of “Psychological Medicine” (Psychiatry) at the Austin Hospital in Heidelberg, Melbourne and senior Professor of Psychiatry at the University of Melbourne.

Professor Burrows, who is also on the “honorary editorial board” of the drug-promoting “MIMS” publishing company and directs many of the organisations mentioned in the pamphlet, was mentioned in Ray Moynihan’s expose of ‘disease-mongering’ by the medical profession in Australia. In Too Much Medicine? the journalist wrote, in 1998:

“In a series on depression in the Medical Journal of Australia (MJA) in 1997, Professor Graham Burrows and colleagues wrote that up to one in five people who visit a GP in this country will be suffering from depressive or anxiety disorders…Three weeks later, in the same MJA series, another psychiatrist Professor Philip Mitchell gave these endorsements to the role of drugs in the treatment of depression. ‘Most patients do best with a combination of antidepressant medications and some form of psychological therapy…the vast majority of depressed patients seen in the general practice setting have mild to moderate depression, for which the new antidepressants are as effective as the old…’ 182

“Associate Professor Mitchell is with the School of Psychiatry at the University of New South Wales, and is the Administrative Director of the Mood Disorders Unit at the Prince of Wales Hospital in Sydney. When questioned about the strong endorsement of drug therapy, even for mild to moderately depressed patients, Professor Mitchell said the wording could have been clearer…”

Moynihan tends to understate the impact of disease creation through the suggestion of “mental illness” and the promotion of diagnoses such as “depression”, but he does make some pertinent points about conflict of interest:

“After reading the first MJA article on the prevalence of these disorders and the second on treatment, the reader might be forgiven for forming the strong impression that up to 20 percent of the Australians who visit a GP could benefit from treatment with the new antidepressants: the medication of a nation on an unprecedented scale [subsequently exceeded by cholesterol lowering drugs]. The other clear message is that depression and related disorders are greatly under-diagnosed. This assumption has been at the centre of the company-sponsored depression- awareness campaigns in Australia as each company promoted its new antidepressant through the 1990s. But are things really as bad as that?

“Professor Burrows’ article stated, ‘A general practitioner who sees 40 patients a day can expect that eight will require support or treatment for anxiety or depression – and that’s not counting those whose disorders go unrecognised’. Yet at almost the same time a major report on the treatment of depression prepared in Britain, while not ruling out that the prevalence might be higher, referred to ‘a prevalence in general practice of about 5 per cent for neurotic and depressive illness…’

“Discrepancies like these are hard to explain. Clearly the larger the prevalence of a disease, the bigger the potential market for those selling drugs. In such a situation it seems reasonable to expect that any relationship between those making the estimates of disease prevalence and the companies selling drugs should be made clear.” (p.144) 183

One of the dominant activities of the Mental Health Foundation is fundraising, and even in death one is exhorted to support their “vital work”. In a grotesque appeal for “Wills and Bequests” the Foundation has produced a tear-off glossy “Form of Bequest” which allows the dying to leave money and possessions “to be used by the Mental Health Foundation of Australia in its work of promoting good mental health to all Australians”.

The smiling face of Professor Graham Burrows explains:

“About one in every five Australians – more than three million people – are suffering mental illness severe enough to significantly affect their lives.

“One person in ten will be hospitalised for mental illness at some time during their lives.

“Mental illness costs at least $3 billion per year for hospital admissions, doctor’s fees and invalid pensions.

“Added to this are the human penalties: marriage breakdown, family disruption and child abuse.

“Stress caused by the economic recession alone is already having an impact on the mental health of millions of Australians.

“Young people especially are at risk with long-term unemployment and homelessness in danger of setting behaviour patterns for a lifetime.

“There is a desperate need to act now to provide people of all ages with the support they need to face the future with hope, confidence and peace of mind.

“We need to make good mental health a vital part of the Australian lifestyle.” 184

Professor Burrows does not make it clear as to what, exactly, “good mental health” is, or how he plans to promote it “for all Australians” but he does make clear that he is prepared to accept anything of value:

“Your bequest may specify the activity you want to support – children, adolescents, corporate stress, aged care, etc. or become a general bequest. You may specify the gift of a part of your estate, or a parcel of shares, debentures or bonds, or a house or other real estate, works of art, antiques or anything of value.”

If in doubt about such a course of action the Mental Health Foundation explains, further, that:

“The Mental Health Foundation of Australia has appointed Trust Company of Australia as trustees of the Mental Health Foundation of Australia Charitable Fund. We would be happy to arrange a meeting with a senior manager if you would like to discuss your will.”

The G-Line is a joint project of the Mental Health Foundation of Victoria, Vic Health and Liberty Victoria. Liberty Victoria is the government sponsored “Human Rights Organisation of Victoria”, previously called the “Victorian Council for Civil Liberties”. G-Line is one of the Mental Health Foundations “OPTIONS projects”. Graham Burrows is described in their promotional literature as being qualified with “AO, KSJ, MD, ChB, BSc, DPM, FRANZCP, FRCPsych, MRACMA, Dip.M.Hlth.Sc (Clinical Hypnosis)” being, in addition to other things, “Professor of Psychiatry, University of Melbourne and Director of the Psychiatry and Psychology Service Unit of the Austin and Repatriation Medical Centre”. He is Chairman of the Options Project, which claims to be “promoting mental health and human rights in the community”.

185

In 1998, the options project produced an advertising pamphlet, with tear-off order form for a 59-paged book titled “Your Guide to Responsible Gambling”, priced at $6 per copy. The book is heralded with the grandiose claim, splashed in red letters above small photos of its two smiling authors:

“This book is a must for everyone! Those who gamble, who know someone who gambles, those who feel they have a gambling problem and everyone with an interest in gambling and its effects.”

The book is authored by Graham Burrows and a psychologist called Greg Coman. In contrast to Graham Burrows long list of honours and degrees Greg Coman’s stated qualification is a humble “MSc”. He is said to be “a psychologist specialising in habit disorders, particularly problem gambling”. He apparently “was instrumental in setting up G-Line, Australia’s 24-hr gambling telephone counselling service” and “is currently researching the potential for telephone counselling as a treatment approach for gambling and other psychological problems”. He is described also as “Treasurer” of the “National Association for Gambling Studies”.

It is ironic that the OPTIONS project claims to be “promoting mental health and human rights in the community” is jointly sponsored by institutions with a long history of atrocious human rights abuses: the psychiatric treatment industry and State Government of Victoria (which controls the Police Force and public hospital system). Added to the irony of this alliance for “human rights” is the collaboration of Liberty Victoria in the options projects. Their name appears at the bottom of the pamphlet advertising Graham Burrow’s new book alongside the logo of VicHealth, but it is unclear as to what their role in the project is.

In 1996 and 1997 two workers from the Victorian Council of Civil Liberties, Konstandinos Karapanagiotidis and Steafan Kilkeary undertook an investigation into official complaint mechanisms for aggrieved psychiatric patients in the State of Victoria. Their findings, after a one year investigation including taped interviews and numerous personal interviews for the “Seeking Justice Project”, 186

confirmed, in addition to a complete failure of these complaint mechanisms, extensive human and civil rights abuses of the most appalling nature occurring in Victoria. This included punitive treatment, heavy drugging, misdiagnosis, unnecessary incarceration, and sexual abuse by psychiatrists. They give examples of women who had been raped or otherwise sexually assaulted being disbelieved and punitively diagnosed and treated by the psychiatric profession and hospital system:

“A woman screaming saying that she had been gang raped by 5 men while on day leave and that she was pregnant as a result of this abuse was not believed by anyone in the psychiatric hospital in which she was a patient. The workers punished her for ‘telling lies’ by not allowing her to see a doctor. It was not until the woman was discovered in a pool of blood, having miscarried, that the workers finally believed her.”

The report, which the Liberty Victoria attempted to prevent the release of, quotes Fran Quigley of the Geelong Rape Crisis Centre who says:

“Women in the psychiatric system are treated in an appalling manner. They are often caught up in the system for a long time…[and] often do not have a mental illness. At one stage they are told they have “schizophrenia” then it suddenly becomes a “personality disorder”. Clearly they are not being assessed properly.”

The report says:

“The sad fact is that the dominant medical model of mental health dictates the way the mental health industry is run. It imposes a biological, victim-blaming approach that diminishes the individual’s capacity for self-understanding and self-fulfilment. By instead concentrating on those damaging and dangerous labels of ‘mental illness’…this results in practices which cause rather than cure distress.”

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The investigation of the Seeking Justice Project was focused on complaint mechanisms, specifically about complainants’ experiences in dealing with the “Office of the Public Advocate”, “Community Visitors’ Program”, “Mental Health Legal Centre”, “Victorian Mental Illness Awareness Council”, “Health Services Commissioner”, “Chief Psychiatrist” and “State Ombudsman”. The authors list several fundamental failures of the existing system, including, “lack of independence” in which they quote Isabel Collins, Executive Officer of the Victorian Mental Illness Awareness Council as saying, “There does not exist in the state of Victoria a single independent body where a consumer can take their complaint and have it dealt with objectively and fairly”. In the same section they write:

“…advocates from The Office of the Public Advocate appear before the Guardianship and Administration Board and actively speak against the wishes of those individuals for whom they are supposed to be advocating. One such example was where the hearsay evidence of an advocate led to an individual having his freedom of movement curtailed.”

Of betrayal by supposed “advocates” they give several examples:

“…in 1996 we witnessed a Community Visitor in Footscray Psychiatric Hospital advocating against an involuntary patient, while pretending to her that he ‘was on her side’. What he was trying to do, without her knowledge or approval, was to have her children permanently placed in the custody of her estranged husband”.

They add:

“It is really disappointing that the statutory complaints mechanisms, all of which have sweeping legislative powers to act against abusive and negligent mental health workers, steadfastly refuse to do so. Particularly when it is understood that lethargy, as Keith Jackson from the Health Services Commissioner put it, is met with ridicule and contempt by workers against whom complaints are made. He stated that psychiatrists for one in Victoria operate ‘as a 188

law unto themselves’. Laughing off even such serious allegations as the sexual assault of a patient. The Ombudsman too, retains the power to initiate investigations on its own behalf, and to name negligent service providers in Parliament. It however remains silent, neutered.”

Referring to a “Climate of Fear” in the Victorian Mental Health System, Karapanagiotidis and Kilkeary, who left Liberty Victoria after the “human rights organization” had refused to release the report, write:

“…almost every mental health worker encountered during the SEEKING JUSTICE Project made some reference to the ‘climate of fear’. With the exception of Dr Carlyle Perera [the State Government-appointed Chief Psychiatrist], who conversely stated that individuals in Victoria now live in a climate of openness.

“A great deal has been written and said about the climate of fear in the mental health industry. Indeed, it was one of the key reasons why Mr Brian Burdekin, then Human Rights and Equal Opportunity Commissioner, reconvened his inquiry into human rights and mental health in Victoria in 1994. It had been stated to Mr Burdekin that any worker who spoke out against the mental health system would be persecuted. Usually by her or his job.”

The human rights workers summarise treatment in the public hospital system:

“…from first contact with the mental health industry the individual’s experience can be typified and normalised by the use of excessive force, copious amounts of mind-stultifying medication, and treatments such as solitary confinement, shock therapy, and stimulus aversion. Treatments which tend to exacerbate rather than alleviate situations of mental unwellness.”

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In the brief conclusion of the report, the authors quote a response from Dr Carlisle Perera, who has since been replaced as the head of State Psychiatric Services by Professor Norman James, previously head of Royal Park (Psychiatric) Hospital in Parkville. They write:

“Dr Carlyle Perera stated that ‘do-gooders’ from organisations such as Liberty Victoria just wanted to rush out there and give ‘them’…their rights. That this would cause them distress and would alienate them from the people who really cared about them (the workers in the mental health industry). This is, at best, a dodgy line of reasoning….The bottom line is that when ‘do- gooders’ such as us talk about human rights, we are talking about everyone’s right to live free from abuse. What came out of the Seeking Justice Project and the Know Your Rights Workshops was that many individuals felt that their rights were being sorely trampled on in Victoria. And that there was nowhere to go to either evince justice, and/or to prevent further abuse.”

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REASONS FOR DIAGNOSIS OF SCHIZOPHRENIA

The fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM IV), published by the APA in 1994, describes “schizophrenia” as follows:

“The essential features of Schizophrenia are a mixture of characteristic signs and symptoms (both positive and negative) that have been present for a significant period of time during a 1- month period (or for a shorter time if successfully treated), with some signs of the disorder persisting for at least 6 months (Criteria A and C). These signs and symptoms are associated with marked social or occupational dysfunction (Criterion B). The disturbance is not better accounted for by Schizoaffective Disorder or a Mood Disorder With Psychotic Features and is not due to the direct physiological effects of a substance or a general medical condition (Criteria D and E). In individuals with a previous diagnosis of Autistic Disorder (or another Pervasive Developmental Disorder), the additional diagnosis of Schizophrenia is warranted only if prominent delusions or hallucinations are present for at least a month (Criterion F). The characteristic symptoms of Schizophrenia involve a range of cognitive and emotional dysfunctions that include perception, inferential thinking, language and communication, behavioral monitoring, affect, fluency and productivity of thought and speech, hedonic capacity, volition and drive, and attention. No single symptom is pathognomonic of Schizophrenia; the diagnosis involves the recognition of a constellation of signs and symptoms associated with impaired occupational and social functioning.” (p.274)

The key features of the “disorder” are “impaired occupational and social functioning”, according to the DSM IV, however “schizophrenia” is not regarded as a social or political label: it is regarded as a mental illness, and more specifically a “brain disease”. This is despite the lack of any specific abnormalities in the chemistry or structure of the brains of diagnosed schizophrenics that cannot be better accounted for by the dopamine-blocking drugs every diagnosed schizophrenic is routinely subjected to. 191

Much time, money and effort have been expended over the years in an effort to prove that “schizophrenics” have subtle “brain abnormalities” and many claims have been made of such discoveries over the years only to be later disproved. Much time, money and effort have also been expended on trying to prove the genetic basis of the disease. This began during the time of open adoption of “eugenic” policies in the countries that developed the theoretical foundations of schizophrenia before the Second World War; and it has continued with little interruption since then.

The Oxford Textbook of Medicine (1996) describes the aetiology of schizophrenia thus:

“Studies of families point strongly to a genetic cause of schizophrenia; for example, the rates of schizophrenia are consistently higher among monozygotic than among dizygotic twins, whilst the adopted away children of schizophrenic parents have rates of schizophrenia similar to those of children brought up by their own schizophrenic parents. Imaging studies of living patients show abnormalities in the temporal lobes of the brain, whilst neuropathological investigations after death confirm abnormalities in the parahippocampal areas, and also suggest that these changes may have originated before birth. These findings have led to the suggestion that an abnormality of brain development predisposes to schizophrenia.

“Whatever the nature of the predisposing causes, the precipitating factors for schizophrenia are stressful life events and occasionally physical illness. Life events are also important causes of relapse after a first episode of schizophrenia.

“Drugs that reduce the positive symptoms have in common the property of reducing dopaminergic transmission in the brain. It does not follow, however, that schizophrenia is caused by excessive dopamine function (similarly anticholinergic drugs control the symptoms of parkinsonism but the primary disorder is not of cholinergic transmission).

“At present these and other findings cannot be integrated into a convincing simple aetiological hypothesis, and it is not known whether all cases have the same aetiology. It would not be 192

surprising if there were more than one cause of the complicated and variable behavioural syndrome of schizophrenia.” (p.4222)

The diverse range of ‘symptoms’ and ‘signs’ attributed to ‘schizophrenia’ are indeed difficult to explain by a simple aetiological hypothesis, or even a complex one. This is especially so when the accepted criteria for diagnosis of the “disorder” are constantly changing, and are both subjective and vague. It is difficult to see how the same “disease”, whether caused by genetically determined or acquired ‘chemical imbalance’ could produce in one person a fear that he is being spied upon by the CIA, in another a belief she is communicating with extra-terrestrials, a third that he is the messiah, a fourth that he is hearing the voice of angels, and a fifth that she is controlled by multinational corporations. It is difficult to see how beliefs, whether factual or delusional, can be explained within a chemical-genetic paradigm, or by structural abnormalities in the brain. Since beliefs are conceived and expressed in words, the roots of delusions are more likely to be found in words, phrases and the ideas that accompany learned words and phrases.

As children learn the vocabulary of the language or languages of their home environment they also gather a growing collection of ideas and beliefs which accompany the words and phrases they acquire. What they believe depends on what they are told and what they “work out for themselves”. People continue to do this throughout their lives: they continue to be told things and to work things out for themselves. Children and adults also acquire beliefs from things they see and hear. Television and radio programs, films and videos, books, magazines and computers feed ideas, words, images and phrases into the growing and often increasingly confused and contradictory belief system of children, while they strive to understand the world and their place within it. In their quest to understand the world, and driven by the common mammalian instinct of curiosity, young children start at the age of two or three, to ask questions.

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This continues, to a greater or lesser degree, throughout life, and, as children grow older they are also asked questions, to which they give increasingly complex answers. All of us have been through this process of learning the basics of verbal communication and philosophical inquiry when we were young children. All of us also had delusional beliefs (beliefs which were inconsistent with reality) when we were children and all of us still do. All of us also have some correct beliefs, as do children. In other words, some of the things we believe are true and some are false.

While this is obvious enough (unless we regard some humans as infallible), it is an unfortunate characteristic of the human being that we usually do not like finding out that we are wrong and usually do not like being corrected. It is unfortunate because this is the only way in which our own incorrect (delusional) beliefs can be corrected.

The learning of language and of one’s belief system is dependent on memory. Without memory there can be no beliefs and no learning. An abnormality in beliefs self-evidently involves an abnormality of memory in that the ‘abnormal belief’ is held in the memory. Even the profession of opinions which are not actually believed (lying or pretence) requires functional memory. One might look, then, at memory, and the areas of the brain involved in the registration and recall of memories, for an explanation of delusions and delusional thinking.

The 1995 American neurosciences textbook Essentials of Neural Science and Behavior claims:

“The prefrontal area of primates and other animals is particularly rich in dopaminergic terminals. This dopaminergic innervation is thought to be an important modulatory input for the storage of working memory. In fact, the delayed [spatial] response [in experimental monkeys] is disrupted when dopamine is depleted from the principal sulcus [of the frontal lobe of monkeys] by means of a localized injection of 6-hydroxydopamine, a drug that selectively 194

destroys terminals that use dopamine as a neurotransmitter. Moreover, disturbances of this dopaminergic system contribute to the symptoms of schizophrenia, a disorder of thought.

“Imaging studies of the brains of schizophrenic patients support this idea. The frontal lobe tends to be smaller in schizophrenics than in normal individuals. Furthermore, whereas blood flow to prefrontal areas increases in normal subjects challenged by a task that engages prefrontal functions, such as with the Wisconsin card sort test, the increase is less in people with schizophrenia.” (p.353)

This textbook is used as a reference text by medical students and doctors in Australia and the USA and is available in university bookshops in Australia. Although no references are provided for these claims, they are stated with dogmatic certainty. The assertions about schizophrenia and ‘schizophrenics’ are couched in scientific language and are presented in a form resembling a logical argument. One statement follows another and the second paragraph purports to provide support for the idea that disturbances of the “dopaminergic system” contribute to the symptoms of schizophrenia.

The preceding sentence, however, is about injections into the brains of monkeys, which are said to produce disturbances of memory through damage to dopaminergic neurones. The connection with ‘schizophrenia’ is logically untenable and scientifically unsound. Most obviously, monkeys are not known to suffer from schizophrenia.

The vital fact that is not mentioned in this attempt to establish the neurological basis of schizophrenia is the standard medical treatment of schizophrenia: injection and prescription of drugs that block dopamine receptors and subsequently kill dopaminergic neurones. One might expect as a logical inference that these drugs could interfere with memory (and other aspects of thought involving dopaminergic neurones), and cause decreased blood flow in areas of the brain with dopaminergic 195

neurones and eventual shrinking (atrophy) of these areas. These have indeed been reported in people who have been diagnosed with and treated for schizophrenia, but the observed changes have been blamed on the disease rather than the drugs. Furthermore, the catecholamine neurotransmitter dopamine is known to be centrally involved in enabling voluntary movement, hence the obvious role of dopamine-blockers as chemical restraints.

Due to the 100 year-old schism between neurology and medical psychiatry, Essentials of Neural Science and Behavior, which deals mainly with neurology, does not discuss schizophrenia (a ‘psychiatric illness’) to any great degree; however what is mentioned is stated with scientifically unjustifiable certainty and in conformity with the views of the American Psychiatric Organization, reinforcing belief in the “biological” (neurological) nature of the diagnosis and the role of chemistry and genes in its aetiology. On page 565 ‘schizophrenia’ is mentioned again, this time in a chapter titled “Genes and Behavior”. Under the dogmatic subheading “Complex Disorders of Human Behavior Such As Schizophrenia and Bipolar Affective Disorder Are Thought to Be Polygenic”, the textbook claims:

“Two of the most striking forms of mental disorder in humans show strong genetic components. These are schizophrenia, a disorder consisting of delusions, auditory hallucinations, and disjointedness of thought, and bipolar affective disorder (manic- depression), consisting of intermittent episodes of extreme mood elevation and overactivity alternating with loss of energy and motivation. Both disorders are present in higher percentages among relatives of affected individuals than in the general population, and both show a significantly higher incidence among identical twins. The likelihood that both twins will be affected is 30 to 50% in identical (monozygotic) but only 10% in fraternal (dizygotic) twins. The higher rate for identical twins holds for twins reared apart as well as those reared together. The 10% fraternal incidence is similar to that of nontwin siblings, but is still much higher than the frequency in the general population (Figure 30-6).” (p.565)

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The figure, from a 1992 statistical analysis by Groves and Rebec comparing “genetic relatedness” with “lifetime risk of developing schizophrenia”, associates identical twins (100% genetic relatedness) with a 46% risk, fraternal twins (50% genetic relatedness) with a 14% risk, and other siblings (also 50% genetic relatedness) with 10% risk. The children of two schizophrenics are reported to also have a 46% risk of receiving this diagnosis, while people with one schizophrenic parent are reported as having a 13% risk. The conclusions drawn, done so in ignorance of the specific propagation of delusions and idiosyncratic modes of thinking within families, biases favouring diagnosis of abnormality in family members (by psychiatrists and researchers), and the possibility of conscious or unconscious telepathic connections between identical twins, are that: “schizophrenia probably results from the concerted actions of many genes, each of which makes only a small contribution” (p.565).

This “polygenic theory” purports to resolve the problem that the family clustering of “schizophrenia” does not occur in a way that supports classical genetics. Identical twins, who have identical DNA complements according to genetic theory, do not have a 100% concordance for schizophrenia, indicating that “nongenetic factors are also important”, according to the textbook.

While these “nongenetic factors” are not elaborated on in Essentials of Neural Science and Behavior, they are in many other texts, including the 1998 US publication Encyclopedia of Mental Health, which mentions “brain abnormalities”, “biochemical factors”, “genetics”, “obstetric complications” and “viral infection” as being associated or linked with the development of schizophrenia. These are integrated into what is termed the “diathesis-stress model”, which is said to have “dominated theories about the etiology of schizophrenia for several decades”:

“This model assumes that certain individuals inherit or acquire a vulnerability to schizophrenia (the diathesis), and that the behavioral expression of this vulnerability is determined or triggered by environmental stressors. Although “stress” was originally conceptualized as psychosocial in origin, contemporary versions of this model broaden the definition of stress to 197

include prenatal and postnatal insults to the central nervous system. Thus the diathesis, combined with exposure to environmental stressors, can produce schizophrenia.” (p.407)

The encyclopaedia strongly refutes the idea that families or parents cause schizophrenia (without considering the phenomenon of shared familial beliefs of an iconoclastic, idiosyncratic or delusional nature), whilst ignoring completely the possibility that psychiatrists and psychologists could cause schizophrenia, beginning the section on the aetiology of schizophrenia with the following statement:

“The causes of schizophrenia are unknown, but it is now widely accepted by both researchers and clinicians that schizophrenia is biologically determined. This is in striking contrast to the early and mid-1900s, when many subscribed to the theory that faulty parenting, especially cold and rejecting mothers, caused schizophrenia in offspring.” (p.404)

The Encyclopedia of Mental Health also states that “family communication styles are unlikely to play a unique causal role in schizophrenia”, presenting a confused and contradictory argument:

“There is good evidence…that exposure to high levels of criticism from family members can increase likelihood of relapse in schizophrenia patients. The number of critical comments, expressions of hostility, and emotional overinvolvement comprise a construct referred to as expressed emotion (EE). Recovering schizophrenia patients in families high in EE are much more likely to have a relapse compared with patients in families low in EE. There is also evidence from studies of the adopted offspring of schizophrenia patients suggesting that familial stress can hasten the onset of symptoms” (p. 407)

The construct of EE is a strange one indeed, and a very misleading and dangerous one at that. On reading this, from such an authoritative source as a contemporary encyclopaedia edited by a 198

psychology professor, families could be excused for thinking that a high level of emotional expression is harmful, while confusing “emotion” with “hostility and criticism”. It is obvious that hostility and frequent criticism are unhealthy attributes for any family and likely to make any distressed person worse. They are, however, more likely to be caused by lack of emotional involvement rather than “overinvolvement”. It is also undoubtedly true that over-controlling or intrusive families can cause distress to the whole family, and especially to dominated and mistreated members, but this is surely not the same as “emotional expression”. Significantly, the encyclopaedia’s discussion of family influences ignores shared familial beliefs and the non-genetic inheritance of beliefs, also shifting blame from “carers” to the “disease” which, by using the term “schizophrenic”, becomes synonymous with the ‘afflicted’ person.

The encyclopaedia, on reference in the Caulfield public library in Melbourne, lists several “brain abnormalities in schizophrenia”, while ignoring the many findings and arguments which cast doubt on these claims:

“There are several sources of evidence for the assumption that schizophrenia involves an abnormality in brain function. First, studies of schizophrenia patients have revealed a variety of behavioral signs of central nervous system impairment, including motor and cognitive dysfunctions. Second, when the brains of patients are examined with in vivo imaging techniques, such as magnetic resonance imaging (MRI), many show abnormalities in brain structure. Similarly, post-mortem studies of brain tissue have revealed irregularities in nerve cell formation and interconnections.

“Laboratory studies of schizophrenia patients have revealed a variety of abnormalities, including irregularities in smooth pursuit eye movements, psychophysiological responses to sensory stimuli, and concentration. Research on the neuropsychological performance of schizophrenia patients was first conducted in the 1950s and continues to the present time. Individual neuropsychological tests are designed to measure functions subserved by specific regions or systems of the brain. An early finding in this area was that schizophrenia patients were the one psychiatric group whose performance on neuropsychological tests was 199

indistinguishable from people with known brain damage. The findings suggested a generalized cerebral dysfunction in schizophrenia. However, patients show the most consistent deficits on tests of attention and memory, indicating dysfunction of the frontal and temporal lobes and the hippocampus. Further evidence of dysfunction in these brain regions is derived from poor performance on tests of executive functions: the ability to formulate, maintain, and adapt appropriate responses to the environment.

“Brain-imaging studies of schizophrenia have yielded results that mirror those obtained from neuropsychological research. Some relatively consistent findings are that the brains of schizophrenia patients have abnormal frontal lobes and enlarged ventricles. Enlarged ventricles suggest decreased brain mass, particularly in the limbic regions, which are intimately involved in emotional processing. Furthermore, ventricular size correlates with negative symptoms, performance deficits on neuropsychological tests, poor response to medication, and poor premorbid adjustment. These associations between ventricular enlargement and both premorbid and postmorbid characteristics suggest that the brain abnormalities are long-standing, perhaps congenital.

“In addition to brain structure, investigators have examined biological indices of brain function in schizophrenia. Functional brain-imaging studies, with procedures such as positron emission tomography (PET) and measurement of regional cerebral blood flow, reveal that schizophrenia patients have decreased levels of blood flow to the frontal lobes, especially while performing cognitive tasks.” (p.404)

What can we make of these findings and the presented interpretation of them: that schizophrenia is caused by brain damage which is caused by a combination of factors, some genetic, some congenital (present at birth, but not necessarily due to abnormal genes) and some environmental (viral infection)? Is the ‘evidence’ merely presented to justify a priori conclusions regarding genetic and brain abnormality? How are we to be certain that larger ventricles, different sized or shaped frontal lobes and differences in blood flow are not variants of normal, which can surely not be judged, in this area, 200

on the basis of ‘bell curves’? If brain damage has occurred, how do we know that it has not been caused by the dopamine-blocking drugs that are ubiquitously used to treat diagnosed ‘schizophrenics’?

In fact, when one looks at the known distribution of dopaminergic neurones in the brain (notably, the frontal lobes, limbic system and basal ganglia), their known involvement in the development of Parkinson’s disease, and the fact that all “anti-psychotic” drugs (with the exception of Clozapine and the so-called new 'atypicals') act primarily as dopamine-receptor blockers (and can cause parkinsonism and other neurotoxic effects), it becomes clear that ventricular enlargement around the limbic regions, death of neurones and cerebral atrophy and reduced blood flow to dopaminergic areas of the brain (such as the frontal lobes, hippocampus and basal ganglia) could be predicted from the known neurotoxicity of the drugs used to treat schizophrenia, rather than from any underlying brain disease. This neurotoxicity is not denied; almost all psychiatric texts admit to the fact that any and all dopamine-blocking drugs can cause “tardive dyskinesia” (a common and crippling form of brain damage that affects many who survive the first insults of schizophrenia) as well as “extrapyramidal side-effects” such as parkinsonism, akathisia and tardive dyskinesia.

Furthermore, many of the “negative symptoms” of schizophrenia, including amotivation and cognitive impairment, which are said to correlate with findings of ventricular enlargement are recognised side- effects of the same drugs, effects which occur at so-called “therapeutic doses”.

It has taken many years for the medical profession to admit that the drugs used in chronic schizophrenia can worsen the “negative symptoms” of the condition. These are said to become more and more prominent as time goes by (“as the disease progresses”). During this time, of course, the cumulative dose of dopamine-receptor blockers has continuously risen, and any damage to neurones consequent on this blockade would also be expected to have increased. 201

Recent admissions of worsening “negative symptoms” are very significant, even if given grudgingly, with reservations, and belatedly. For example, in February 2000 article titled ‘New Developments in Schizophrenia’, Melbourne psychiatrists Nicholas Keks and Robert Shields admit that:

“Negative symptoms (flat affect, poverty of thought, lack of motivation) characterise schizophrenic deficit. These symptoms may well be due to hypofunction of the frontal lobe of the brain, and are poorly responsive to (or even exacerbated by) conventional antipsychotics if parkinsonism is induced” (p.129)

The so-called ‘negative symptoms’ of schizophrenia such as ‘flat affect’, ‘poverty of speech’ and ‘avolition’ which characterise the later ‘progression of the disease’ have long been regarded as ‘relatively unresponsive to drugs’ as opposed to ‘positive symptoms’ such as hallucinations which characterise the ‘early stages of the disease’. Although critics of these drugs have pointed out for several decades that the ‘side-effects’ of these drugs are remarkably similar to the ‘negative’ symptoms and signs of chronic schizophrenia, it is rare to see an admission from psychiatrists that dopamine- blockers can aggravate these problems (as opposed to being ‘ineffective’ against them). While all of ‘schizophrenia’ cannot be explained as a consequence of drug treatment, the ‘negative symptoms’ of ‘chronic schizophrenia’ are worth looking at in the light of the known side-effects and long-term effects of the drugs used to treat acute and chronic schizophrenia, and the known psychological and behavioural effects of serious abuse and torture.

As far as ‘simple aetiological theories’ are concerned, the “reaction-to-torture theory of chronic schizophrenia” combined with known effects of dopamine-blockers explains a surprising number of the key ‘symptoms and signs’ of the ‘chronic’ disease as well as the ‘behavioural abnormalities’ which are described in textbooks and seen in psychiatric wards and clinics.

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Accepting that one is mad is painful, and being forced to accept that one is mad is also painful. ‘Torture’ is defined in the Heinemann Australian dictionary as “the inflicting of extreme pain”. The Oxford School Dictionary defines ‘torture’ as “infliction of severe bodily pain, esp. to extort something from the victim; severe physical or mental pain”. Both physical and psychological pain cause suffering, and this suffering continues for a variable period of time as a result of the injury itself and the memory of it. In the case of treatment for schizophrenia the pain is more psychological than physical, although injections of dopamine-blockers (and their side-effects) can be physically painful.

The memory of severe pain (physical or mental) also causes fear and avoidance of things associated with the pain, thus affecting behaviour in often noticeable ways. Severe pain can also cause problems in the clarity of thought and the fluency of speech, as can anxiety, and its extremes, panic and terror. Torture, including chemical torture and psychological abuse (including solitary confinement and constant denigration or criticism) can also cause anxiety (chronic fear), panic and terror during and after the mistreatment. It can result in paranoia and even hallucinations. It can elicit defiant, oppositional, hostile, suspicious, rude or ‘sullen’ behaviour (which can easily be interpreted as ‘inappropriate affect’, ‘catatonia’, ‘echolalia’ or ‘poverty of speech’) or, if it ‘breaks the spirit’ of the tortured subject, torture can produce dependent, fearful compliance.

The medical (psychiatric) term “affect” is often equated with emotion and feeling, however the term is actually used to describe the observed appearance of patients’ emotional state: this being judged on the diagnoser’s interpretation of the emotion the patient shows as opposed to the emotion he or she actually feels. This is an important point to remember when considering two “abnormalities of affect” which are regarded as characteristic of schizophrenia: “inappropriate affect” and “flattened affect”.

The classical example of “inappropriate affect”, which was included in Bleuler’s initial description of schizophrenia is that of a person who laughs upon hearing of the death of a loved one. To Bleuler this 203

reflected as split or dissociation between ‘thought and affect’. Of course there are many other ways of explaining why a person may laugh when hearing of the death of a loved one. Most people are familiar with ‘nervous laughter’, when ‘normal’ people feel like laughing because they feel uncomfortable. People can also laugh because of shock or surprise.

On the other hand maybe they didn’t actually love their ‘loved one’. Hatred exists within families: between siblings, between parents and children. Of great concern is that rather than understanding the puzzling emotional reaction of the ‘schizophrenic’ the term ‘inappropriate affect’ provides a label which may be mistaken for an genuine explanation. No effort is made to understand what it is assumed is to be inexplicable. Even worse, the term has massive potential for abuse and the justification of abuse. The ‘schizophrenic’ who shows indifference, amusement or irritation when ordered or scolded may be judged as showing “inappropriate affect”. The person who weeps with “no obvious reason” may be seen as showing evidence of their “brain damage” rather than reacting to real stresses and expressing real distress.

The more commonly described ‘sign’ of ‘flat affect’ refers to the (outward) appearance of emotional flatness, and is to be differentiated from ‘anhedonia’, which is a subjective feeling of “lack of pleasure” (or enjoyment). While both are described as characteristic of chronic schizophrenia, the term ‘flat’ or ‘flattened’ affect is much more commonly seen in psychiatric texts and patients’ medical records. This ‘flatness’, like any other assessment of ‘affect’ is largely judged on outward appearance: especially facial expression and speech patterns. The sign of “flat affect” is regarded as a typical sign of chronic schizophrenia. Is this “flat affect” of chronic schizophrenics a result of intrinsic brain disease or is it caused by chemical and psychological damage inflicted by medical treatment?

It is well established that dopamine-blockers routinely cause muscular stiffness in the face as well as general muscle stiffness. This is a typical sign of parkinsonism, a recognised ‘side-effect’ of these 204

drugs, whether ingested or injected. The 1993 MIMS Annual describes the “central nervous system” adverse effects of Haldol Decanoate as follows:

“Extrapyramidal. Reactions such as Parkinson-like symptoms, akathisia or dystonic reactions occur frequently with neuroleptics [dopamine-blockers] including oral and injectable haloperidol. In most patients, Parkinson-like symptoms, when first observed, were usually mild to moderately severe and usually reversible. They are more commonly observed during the first few days of treatment, however Parkinson rigidity, tremor and akithisia tend to appear less rapidly. They sometimes remit spontaneously when treatment continues, or can be relieved by the use of antiparkinson medication or a reduction in dose. Antiparkinson drugs of the cholinergic type should only be used when required because of their potential to impair the efficacy of Haldol Decanoate.

Other types of neuromuscular reactions (motor restlessness, dystonia, akathisia, hyperreflexia, opisthotonus, oculogyric crises) have been reported far less frequently, but were often more severe.

Akathisia is best managed by a reduction in dosage in conjunction with the temporary use of an oral antiparkinson drug. Dystonias which can lead to laryngeal [throat] spasm or bronchospasm may be controlled with amylobarbitone or injectable antiparkinson agents. Extrapyramidal reactions appear to be dose related.

Tardive Dyskinesia. May appear in some patients on long-term therapy or may appear after drug therapy has been discontinued. The risk seems to be greater in elderly patients on high dose therapy, especially females. The symptoms are persistent and in some patients appear to be irreversible. The syndrome is characterised by rhythmical involuntary movements of the tongue, face, mouth or jaw (e.g., protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements). Sometimes these may be accompanied by involuntary movements of the extremities. There is no known effective treatment for tardive dyskinesia; antiparkinsonian agents usually do not alleviate the symptoms of this syndrome. It is suggested that the dosage of all antipsychotic agents be progressively reduced with a view to discontinuation if possible. 205

Should it be necessary to reinstitute treatment or increase the dosage of the agent, or switch to a different antipsychotic agent, the syndrome may be masked. It has been reported that fine vermicular movements of the tongue may be an early sign of the syndrome, and, if the medication is stopped at that time, the full syndrome may not develop.

Tardive dystonia. Tardive dystonia, not associated with the above syndrome, has also been reported. It is characterised by delayed onset of choreic or dystonic movements, is often persistent, and has the potential of becoming irreversible.

Other central nervous system effects. Sedation, insomnia, restlessness, anxiety, euphoria, agitation, drowsiness, depression, lethargy, headache, confusion, vertigo, exacerbation of psychotic symptoms including hallucinations, and catatonic-like behavioural states which may be responsive to drug withdrawal and/or treatment with anticholinergic drugs. Grand mal seizures can be precipitated in previously controlled epileptic patients.

Neuroleptic malignant syndrome. As with other neuroleptic drugs, a symptom complex sometimes referred to as neuromalignant malignant syndrome (NMS) has been reported. Cardinal features of NMS are hyperpyrexia [high fever], muscle rigidity, altered mental status (including catatonic signs) and evidence of autonomic instability (irregular pulse or blood pressure). Additional signs may include elevated creatine phosphokinase, myoglobinuria (rhabdomyolysis) and acute renal [kidney] failure. NMS is potentially fatal, requires intensive symptomatic treatment and immediate discontinuation of neuroleptic treatment.” (p.3-194)

This list of central nervous system (CNS) ‘adverse effects’ is provided by the Belgian drug company Janssen-Cilag which manufactures and markets Haldol (haloperidol) and Droleptan (droperidol) injections in Australasia along with the 'atypical antipsychotic' Risperdal (risperidone) which selectively blocks serotonin and dopamine receptors. Similar ‘prescribing information’ is provided to doctors by other sellers of dopamine blockers, including the French company Rhone-Poulenc Rorer (Largactil), the Danish company Lundbeck (Fluanzol) and the US-UK companies Bristol-Myers- Squibb (Modecate, Anatensol) and Smith Kline Beecham (Stelazine). 206

All these drug companies admit in their prescribing information that the “antipsychotic agents” they market can cause and have caused permanent brain damage: because tardive dyskinesia, which can result from any and all dopamine-blockers, is obviously the result of irreversible damage to the brain. It is not an uncommon problem, either. Psychiatric texts admit to an incidence of 20 percent in people receiving long-term treatment (Copolov, 1994). Since it may be ‘masked’ by other drugs, and is frequently not recognised or reported, the true incidence is likely to be much higher (as a careful observation of people in many nursing homes and psychiatric wards suggests). It is also one of the most disfiguring (and hence stigmatising) of iatrogenic conditions. A person seized by uncontrollable tics, twitches and spasms is predictably viewed with apprehension by those who do not know what has caused the condition.

It is easy to see how this “odd behaviour” may mistakenly be attributed to mental abnormality, especially given the grotesque and bizarre movements (including cheek-puffing and tongue-protrusion) that characterise the syndrome. It is not unusual for patients too, who are rarely warned about tardive dyskinesia, akathisia and other signs of neurotoxicity, to mistakenly attribute drug side-effects to ‘their illness’.

This raises the question of “informed consent” and also sheds light on the aetiology of “chronic schizophrenia”.

How complete should be the information that psychiatric patients (and their families) are given about the dangers and risks of the drugs they are advised or forced to take? How much of the illness called “chronic schizophrenia” is a direct result of drug-related neurotoxicity?

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It is significant that few doctors would or do take these drugs themselves (in contrast to antidepressants and ‘minor’ tranquillisers, which are more frequently consumed by members of the medical profession). The main reason medical practitioners are reluctant to take dopamine-blockers, even if they recognise or regard themselves as deluded or psychotic, is because of the immediate adverse effects and long-term risk of brain damage in the form of tardive dyskinesia.

More often, doctors, like most people, do not doubt their own sanity, even if they recognise themselves as being “stressed”, “cranky” or confused. Rather than regarding themselves as “irritable” doctors, like most people, are more likely to say they are “irritated” (in other words, it is justifiable and caused by external forces). Predictably, if they do start to recognise their own psychosis or delusions doctors are more likely to hide them or deny them (often even to themselves). They know, better than most, the problems with medical treatment of madness, and the terrible consequences of being seen as mad by colleagues, family and friends.

Despite paying lip service to the importance of “informed consent”, when it comes to drugs, and psychiatric drugs in particular, most doctors make an exception. It is almost unheard of for patients to be informed of every risk and danger listed in the prescribing information for the drugs they are prescribed because of time constraints and also the fact that they are much less likely to “comply with medication”.

It is assumed by most doctors that encouraging “compliance” is an important part of clinical practice, especially in chronic (long-term) problems, such as hypertension, hyperlipidaemia and asthma. Doctors do not encourage the ingestion of all drugs, however, and many doctors try to prescribe the minimum amount of medication necessary. With antibiotics and sleeping tablets, for example, nowadays most of the pressure to prescribe comes from the public rather than from the medical profession (although the prescribing habits of doctors over the past forty years caused the problem in the first place). In the case 208

of psychiatric drugs the pressure to prescribe comes from different sources depending on the type (class) of drug and its effects. The psychiatric profession is also the branch of the medical profession that is entrusted with diagnosis and treatment of drug addiction and “drug-addicts”.

It is clearly important for doctors to discourage drug taking as a general phenomenon, prescribing necessary medication only after careful and objective balancing of benefits versus risks based on the best available scientific evidence. This medication should be prescribed according to the fundamental principle of minimum necessary dose for minimum necessary duration. The key word here is “necessary”. Doses can be too large, in which case they are more likely to cause toxicity and are a waste of money. They can also be too small, in which case they are not therapeutically effective (so the illness is not cured or recurs after the medication is ceased). Medicines can be continued for too long, in which case poisoning can occur, especially if the drug accumulates or is slowly metabolised and excreted. If a medicine is stopped too soon, as in the case with antibiotics for bacterial infections, the illness can recur, while if it was continued for longer it might not have. These are subtle and often difficult decisions to make.

Several forces prevail upon doctors to prescribe more drugs at higher doses and for a longer duration than is scientifically warranted. These come from within the profession, from the public and from the companies that sell the drugs they prescribe. The motivations behind these forces are fundamentally different.

The pressure to prescribe from the medical profession, regardless of how misguided, is largely driven by good ideological motives, with a primary objective of improvement in health of the person for whom the drug is prescribed, although it is unfortunately true that doctors do, at times, deliberately or unconsciously “over-treat” for pecuniary benefit, or poison people because of their faith in the drugs 209

they prescribe. (The case of forced treatment with dopamine-blockers is an important exception regarding the generally benign nature of medical therapeutic intent, as will be seen).

The pressure from the public is also usually ideologically driven: a person who asks a doctor to prescribe them a drug presumably believes its ingestion will improve his or her health in some way. This may be to relieve their distress, remedy their illness or maintain their long-term health. They may seek a drug to satisfy physiological or psychological addiction, or, occasionally with the deliberate intent of ‘getting high’. The latter is uncommon and largely limited to benzodiazepine tranquillizers, opiates and stimulants (there is no such demand for dopamine-blockers).

The pressure to prescribe from the pharmaceutical industry is economically, rather than ideologically driven. The primary motive of drug companies is increased profit from sales of their drugs. This profit obviously increases with bigger doses for more reasons and longer periods of time. Profits also increase if drugs are prescribed for more reasons and in combination with other drugs from the same company. Looking across the spectrum of modern drugs it is easy to find situations where the overuse of one drug results in increased sales of other drugs to counter or prevent ‘side-effects’ from the first. In the area of psychiatry ‘polypharmacy’ (prescription of multiple drugs) is common, and increasing. People diagnosed with schizophrenia in Australia are often given several drugs at the same time, some oral and some injected. In Australia today, it is not unusual to find people being given two-weekly or monthly injections of ‘depot’ antipsychotics while also being prescribed oral antipsychotics plus benzodiazepine tranquillizers together with anti-parkinsonism drugs (usually Cogentin) and to remain on this combination for many years. The life of such people is predictably shortened by such treatment.

Adding to the problem of psychiatric drug toxicity is the fact that dopamine-blockers are often given in massive doses, especially to people diagnosed as ‘acutely schizophrenic’ or ‘manic’. This usually occurs away from the eyes of the public and most doctors, in the confines of locked psychiatric wards 210

where it is not unusual to see people rendered stuporose by huge doses of injected dopamine-blockers. It is also not unusual to see people shaking, shuffling, pacing, dribbling and twitching from the injections and tablets they have been given.

The class of drugs referred to here as “dopamine-blockers” are known by many other names, most of which are euphemistic and scientifically inaccurate. First called “major tranquillizers”, drugs which selectively block dopamine-receptors in the brain are also referred to as “neuroleptics”, “psychotropics” and “antipsychotics”. The last of these is the most commonly used term in modern psychiatric literature, although the others are also still used, especially in hospitals and clinics. Older textbooks use these terms interchangeably. All members of this class of drug can cause tardive dyskinesia, parkinsonism and the other neurotoxic effects quoted from the MIMS Annual in reference to haloperidol.

They are also credited with being the greatest triumphs of psychopharmacology and are said to have revolutionized the treatment of psychoses generally and schizophrenia in particular.

Since chlorpromazine (Thorazine in the USA, Largactil in Australia) was introduced into the psychiatric armamentarium in the 1950s, there is said to have been an “opening of the back wards”, progressive de-institutionalization and an ability to “care for the mentally ill in the community”. The Australian health care system has long prided itself with being at the forefront of such improvements, and we are frequently reminded that it is only because of ‘antipsychotic drugs’ that this has become possible.

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Is this true or is this hype from those keen to form an impression that the undeniably atrocious past has been rectified? Are dopamine-blockers crippling chemical restraints or are they miraculous medicines? Are they being given to the right people for the right reasons (being genuine therapeutic ones), or are they being misused for political and social coercion and control in Australia, Britain, the USA and elsewhere in the “free world” as they indisputably were in the “Eastern Bloc”?

212

SOCIAL CONTROL AND DELUSIONS OF CONTROL

When it was revealed in the West that Russian psychiatry diagnosed schizophrenia (or delusions) on the basis of “paranoia” or “persecutory ideas” about the KGB, this was understandably seen as evidence of political manipulation of medical concepts. However, when North American psychiatry texts refer to paranoia about the FBI or CIA, and British texts make equivalent claims about ‘paranoia’ regarding MI5, health professionals in these nations (and even in Australia) have difficulty seeing what they can so easily perceive in their old Cold War enemies.

The chapter on schizophrenia in the 1998 US publication, Encyclopedia of Mental Health defines the “serious mental illness that afflicts 1% of the population at some point of time in their lifetime” as “a psychotic disorder characterized by disturbances in thought, emotion, and behavior” (p.399). The authors of the chapter, Jason Schiffman and Elaine Walker of Emory University (in the USA) refer to the DSM IV criteria for diagnosis of schizophrenia with deference, and provide definitions and examples consistent with the “mainstream psychiatric paradigm” of the USA:

“The term psychotic refers to symptoms that indicate an impairment in the patient’s ability to comprehend reality. This includes beliefs that have no basis in reality and that are not susceptible to corrective feedback (delusions), and sensory perceptions that have no identifiable external source (hallucinations). In addition to hallucinations and delusions, the DSM lists three other key symptoms of schizophrenia: disorganized speech, disorganized or catatonic behavior, and negative symptoms.” (p.399)

This definition of “delusions” being “beliefs that have no basis in reality”, is significantly different to absolutely false beliefs, and one which lends doubt to the examples given in same text of “delusions of control”, presented as typical of “schizophrenia”: 213

“Delusions of control is the belief that one is being manipulated by an external force, often a powerful individual or organization (e.g., the FBI) that has malevolent intent.” (p.399)

It is incongruous that the example of the FBI should be used in this American text, and related “delusions of control” explained as due to “biological disease” of a genetic or congenital nature. Any beliefs about the (US) Federal Bureau of Intelligence (FBI), including both delusional and accurate ones, are obviously learned, including the words themselves (“federal”, “bureau”, “intelligence”). The same can be said for the Central Intelligence Agency (CIA) and other political organizations. These agencies in particular are notable for their secrecy and therefore predictably feature in many people’s concerns and suspicions about clandestine police-military activities (such as surveillance, psy-ops and assassinations) in the USA and even outside the United States.

While not denying that people can be mistaken (and thus deluded in an absolute sense of the word) about being spied on or manipulated, such beliefs are neither inexplicable or entirely without basis: theoretically everyone is a target of international espionage and police-military propaganda.

In Australia, candidates for diagnosis of ‘delusions of control’ include those with supposedly paranoid ideas about either of these American organizations or of ASIO (the Australian Security Intelligence Organisation), MI5, KGB, Mossad, the Freemasons, the Mafia or any other secretive organization. The opinion, or even concern, that these, or any other organization or agency, have specific malevolent intent towards an individual are deemed, according to psychiatric theory and common practice, to be indicative of “persecutory delusions” [related to but different from ‘delusions of control], as are beliefs of individual persecution by employers, insurance companies, large or small corporations, family members or government agencies.

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Concern that these organizations, with the exception of the Mafia and KGB, might have malevolent intent towards humanity or are involved in clandestine or overt conspiracies is also regarded as delusional and paranoid: the official view that the police and military (and associated ‘intelligence agencies’) protect (rather than spy on, manipulate, oppress or persecute) the public is to be accepted, despite plenty of historical examples to the contrary.

If not absolutely altruistic, the activities of the CIA, FBI etc are regarded as, firstly, morally acceptable and secondly, far removed from the experience of the “psychiatric patient” the “therapist” and the “public”. In other words, the CIA and FBI are assumed to go after “baddies” (‘villains’), and therefore psychiatric patients who fear that they may be or are being targeted are regarded as deluded, since they are not “bad” but “ill”.

The distinction between “bad” and “mad” is, however, blurred in medicine as it is in the general population. Few people do not make judgements of “badness” and “madness” in other people (less often themselves), and often no distinction is made between the two. In fact the most evil and inexplicably brutal, cruel or terrible actions are frequently described colloquially as “mad”, along with the people who commit them. Not surprisingly many members of the public assume that it is the “medically diagnosed mad”, i.e., ‘schizophrenics’ and the ‘seriously mentally ill’ who are most likely to do these ‘mad’ things, imagining unstable ‘psychotic’ people hearing commanding hallucinatory voices telling them to commit murder or harm themselves.

While it is true that in very rare instances such things have occurred (usually after, rather than before, psychiatric treatment), exponentially larger numbers have died as a result of very audible commands given by police and military organizations of various nations over the past 100 years. Considering the number who have died because of drugs they were given by the medical profession either in too big a dose, for the wrong reasons, or in dangerous combinations (a figure in the thousands per year in 215

Australia, according to official figures), it is clear that even the (generally) well-meaning efforts of the medical profession claim more lives than the diagnosed “mentally ill” do.

Unlike other medical specialists, psychiatrists have the legal authority to force treatment on people and incarcerate them for the purpose of assessment and treatment. This, legally, can only be done if the person is judged to pose a risk to themselves or others. Corresponding stipulation is contained within International Law as well as the various Mental Health Acts of different States. Also safeguarding against the pernicious use of this authority are various laws and International Covenants proclaiming freedom of speech and freedom of thought.

In Australia, the Mental Health Acts of different States contain a list of reasons why people may not be regarded as mentally ill. Section 8(2) of the Victorian Mental Health Act (1986) reads:

“A person is not to be considered to be mentally ill by reason only of any one or more of the following:

(a) That the person expresses or refuses or fails to express a particular political opinion or belief;

(b) That the person expresses or refuses or fails to express a particular religious opinion or belief;

(c) That the person expresses or refuses or fails to express a particular philosophy;

(d) That the person expresses or refuses or fails to express a particular sexual preference or sexual orientation; 216

(e) That the person engages in or refuses or fails to engage in a particular political activity;

(f) That the person engages in or refuses or fails to engage in a particular religious activity;

(g) That the person engages in sexual promiscuity;

(h) That the person engages in immoral conduct;

(i) That the person engages in illegal conduct;

(j) That the person is intellectually disabled

(k) That the person takes drugs or alcohol;

(l) That the person has an antisocial personality;”

The wording of the exclusion criteria in Section 8(2) contains a loophole which is routinely used by psychiatrists who have made diagnoses involving the prohibited reasons (religious, political and philosophical beliefs, sexual promiscuity, drug use etc.). This is the phrase “by reason only of any one or more of the following”, and the use of the word “only”. It is said, therefore, that people have “affective” symptoms, “mood disorders”, “thought disorder”, “paranoia” and the like. The fact that the person might be judged as “paranoid” because of their religious, philosophical or political beliefs is obscured (and denied) by the use of psychiatric jargon.

In Australia it is the public hospital system in which most forced psychiatric treatment occurs. The large majority of those who are injected or given electric shocks to the brain against their will have 217

been diagnosed with schizophrenia or manic-depression. In a ‘catch-22’ situation for psychiatric patients, “mental illness’ generally, and schizophrenia and mania in particular, is said, in psychiatric texts, to be characterised by “lack of insight”, especially in the “early stages of the illness”. “Lack of insight” refers to failure of the “patient” to accept that they are ill, and inevitably, that they require treatment with drugs which may well make them feel ill. The gaining of insight, by this token, is acceptance that one is seriously and chronically ill and that recurrence of “illness” is inevitable if the drugs are stopped “against medical advice”. Consequently, any “improvement in behaviour” is attributed to efficacy of the drugs while any deterioration is blamed on the “underlying disease process” or, more commonly, “lack of compliance”.

“Lack of compliance”, meaning refusal or failure to take the prescribed drugs is said to be, along with “lack of insight” (and related to it), a common feature of “schizophrenics” and “manic-depressives”. Ensuring compliance with drug taking is consequently an obsession of “mental health workers” in the public psychiatric system in Australia, including doctors, nurses, social workers and psychologists.

The vast majority of health workers who encourage and enforce compliance with drugs and work towards “assisting the patient to gain insight” have awareness neither of the socio-political role of what they do, nor of the influence of the pharmaceutical industry on their beliefs about mental health and mental illness. The vast majority of doctors who make or concur with a diagnosis of “schizophrenia” have no idea of the history of systematic abuse which has accompanied the ever-changing use of the term, or of the massive influence the pharmaceutical industry has had on their belief systems, including their beliefs about what constitutes madness and what can and should be done about it. Few doubt the validity of the term “schizophrenia” or the reality of the disease, nor do they doubt that it is caused by underlying brain disease tending to run in families. Few know the real history of the term, or the way its use has changed over the years.

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SELF-FULFILLING PROPHESIES

One problem with labels such as “schizophrenia” is that they can become self-fulfilling prophesies. The mechanism by which self-fulfilling prophesies become realised is logically obvious, especially in the area of mental illness. While it may be that thinking one has cancer makes it more likely that one develop the disease, it is not a common or inevitable consequence of such belief. This is very different in the case of “schizophrenia”, “depression”, “personality disorder” or “bipolar affective disorder” (manic-depression). Such labels can create mental disturbance through effects on both the person labelled and other people, including therapists, family and friends.

The obvious way in which the word ‘schizophrenia’ can cause illness in one diagnosed with it is through the process of suggestion. People who believe they have a chronic, serious, incurable disease become disturbed merely through such beliefs. They become prone to blaming “their illness” for their past and present problems, and, since the illness is said to be incurable, despair of the future. This is one obvious and studiously ignored reason why people diagnosed with schizophrenia (or manic- depression) might be expected to have an increased rate of suicide. As previously mentioned, between 5 and 15 percent of people diagnosed with schizophrenia are said, in psychiatric texts, to commit suicide.

The second factor contributing to self-fulfilling prophesies in ‘mental illness’ is the treatment that people thus diagnosed are given: both the drug treatment and the “psychotherapy/behavioural therapy”. Freudian psychoanalysis and similar styles of psychoanalysis with deeply misanthropic views of human nature are predictably unsuccessful in the treatment of mentally disturbed people, and can disturb people who were not previously disturbed, again through the process of suggestion. Even in the USA and Europe where Freudian psychoanalysis has gained the most acceptance, such “psychotherapy” is recognised as useless and potentially disastrous in people who have 219

“schizophrenia” and other “psychotic disorders”. The treatment of these conditions is centred on ensuring drug compliance with “antipsychotic drugs”. These drugs, first developed in the 1950s, have a common pharmaceutical action: they block receptors for the neurotransmitter dopamine in the brain. This is thought to be responsible for the efficacy of the drugs as well as their well-recognised side- effects including parkinsonism and tardive dyskinesia. The latter is the result of often irreversible brain damage and occurs in 20 percent of people “on chronic treatment”, according to Professor David Copolov in Foundations of Clinical Psychiatry (p.385). The development of tardive dyskinesia, one of the most terrible of all iatrogenic conditions, is thought to be more likely with injected than oral dopamine-blockers, and it is hoped that the new ‘atypical’ antipsychotics (such as olanzapine, and risperidone) will cause less tardive dyskinesia than the older drugs such as chlorpromazine (Largactil), haloperidol (Haldol), fluphenazine (Modecate) and trifluoperazine (Stelazine). The long and short term use of these drugs, which have formed the mainstay of medical treatment of schizophrenia for five decades, have been responsible for the premature death of thousands of people and the crippling of millions. The reasons for this include neurotoxicity producing tardive dyskinesia and other iatrogenic problems including those listed in the prescribing information for Haldol, some of which were previously described.

The third force in the self-fulfilling nature of the label of ‘schizophrenia’ is the effect of stigmatization in the sight of others, including family, friends, peers and organizations which discriminate against people with “mental illness”. While the problem of stigmatization is recognised as a serious one by the psychiatric profession, it is generally blamed on ‘ignorance’, with the implication that “better education” and “more education” will reduce the community prejudice and negative preconceptions which contribute so obviously to the isolation and distress of psychiatric patients and “schizophrenics” in particular. A close look at the available educational literature, even that specifically addressing the problem of stigmatization, reveals that most could be predicted to reinforce and worsen existing misconceptions and prejudices rather than dispel them.

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There is a great deal of “public education material” available in Australia on the subject of “schizophrenia”. This is freely available at psychiatric institutions such as hospitals and clinics, and also from “Non-Government Organizations” (NGOs) such as the “Mental Health Foundation” and the “Schizophrenia Fellowship”. Some of this information is directed at patients and some at their “carers” and family. In recent years a telling change has occurred in this literature regarding the people who have been diagnosed as having “schizophrenia” or some other “mental illness”. They are now described as “clients” or even more inappropriately, “consumers”. These terms are euphemistic and misleading because firstly, the clients/consumers are often not being treated because of their own free will: they are not clients in the sense that they have sought the ‘services’ provided, which are often being forced on them. Secondly, many are not “consuming” anything provided by the mental health services: they are being injected (with or without their agreement) or being given electric shocks (with or without their agreement). The vast majority of psychiatric patients do, however, consume the drugs they are ordered to take. The majority also accept that they have “schizophrenia” and often that this makes them “schizophrenics”. This is not surprising given the consequence of refusing to accept the diagnosis: repeated incarceration and larger, more frequent doses of injected dopamine-blockers.

One way in which the “educational literature” creates stigma is by the myths it repeats which claiming to refute them. For example, when a pamphlet from the (Australian) National Mental Health Strategy of the late 1990s titled “What is schizophrenia?” asks the question “Are people with schizophrenia dangerous?”, the misleading answer given is:

“No. People with schizophrenia are generally not dangerous when receiving appropriate treatment. However, a minority of people with the disorder become aggressive when experiencing an acute episode, because of their fears. This is usually expressed to family and friends – very rarely to strangers.”

The insinuation is that schizophrenics who are refusing or “not complying” with prescribed treatment are dangerous. Another insinuation is that “untreated schizophrenia” causes fears and aggression. The 221

“treated schizophrenic” who has been “quiet and well behaved” but becomes fearful or angry is not doing so because of legitimate feelings about the treatment he or she has been given but because of “relapse” (for which, of course, lack of compliance with drugs is routinely suspected). The “public educational literature”, magazine and journal articles, and textbook descriptions never question the actual existence of schizophrenia as a biological disease as real as diabetes or cancer. It is unanimously regarded as a serious mental illness; in fact some have gone as far as to describe it as the “cancer of the mind”. This is despite the open admission that the term “schizophrenia” is a misnomer. Under the title “Myths, Misunderstanding and Facts”, the same Mental Health Strategy pamphlet gives this answer to “Do people with schizophrenia have a ‘split personality’?”:

“No. There is no such thing as a ‘split personality’. Schizophrenia refers to the change in the person’s mental function, where thoughts and perceptions become disordered.”

The term ‘disorder’ is used frequently in modern psychiatry. It is commonly regarded in this area of medicine (and in clinical psychology) as synonymous with the words “illness” and “abnormality”. Illness, being the opposite of health, is not, though, the same as ‘disorder’ or ‘abnormality’, especially in the area of mental activity. Normality is a description of what is usual or typical. Biostatistically, ‘normal’ has a specific meaning: the area under a ‘bell curve’ between the second standard deviations in either direction. Such concepts of ‘normality’ are familiar in the form of weight and height percentile charts, which are used to assess the growth of children. By such models, those children more than two standard deviations below the median or two above are ‘abnormal’, and the 97 per cent of children within these limits are ‘normal’. If similar tools are used in the psychological sciences, the ridiculous situation results where exceptionally gifted people are regarded as ‘abnormal’ because they fall outside the limits of what is usual or typical. Genius, by this token, is serious abnormality. Any unique idea or ability is abnormal if that not possessed by the majority is regarded as so.

Over the past twenty years statistics have replaced verbal logic and inductive thinking as the main tools with which psychologists and psychiatrists have attempted to understand human behaviour. Thus we 222

have the Diagnostic and Statistical Manual of Mental Disorders as the bible of the psychiatric profession and now even of the psychology profession. Although pertinent criticism of the labelling mentality exemplified by the DSM is still heard from psychologists (such as Seth Farber) and a few psychiatrists (notably Thomas Szasz and Peter Breggin), basic acceptance of terms such as “schizophrenia”, “attention deficit disorder”, “bipolar affective disorder” etc is the rule, especially among hospital-based clinical psychologists. A corresponding assumption of the importance of medication is common, especially for the so-called “organic psychoses”, schizophrenia, schizo- affective disorder and manic-depression. The treatment of people diagnosed with these ‘psychoses’ is widely regarded as outside the therapeutic capability of ‘talk therapists’, such as psychologists, and it is commonly held that psychotherapy is ineffective in the treatment of psychosis and delusions. This belief is not new, and has been actively propagated by the medical (psychiatric) profession over the years. For example, the third edition of Brian Davies’ “An Introduction to Clinical Psychiatry”, published by Melbourne University Press in 1981 gives the following advice regarding “supportive care” of “schizophrenic patients and their families” (with their italics):

“The social and personal problems that these patients develop can often be minimized by regular supportive care from one interested doctor. He must be prepared to look after these young patients who usually have considerable problems in their relationships with other people. The illness may develop at a time when engagement and marriage problems are to the fore, and supportive care through these times, as well as any pregnancies, needs considerable clinical skill. Psychotherapy proper is contra-indicated for these people.” (p.132)

He goes on to present a picture of chronic schizophrenia that could surely be avoided if proper psychotherapy were given to people who are acutely disturbed:

“Unfortunately, despite the best possible care, relapses occur. Sometimes this is associated with the patient stopping the tranquillizing drugs. Further hospital admissions may be necessary, but these should be as brief as possible. It is not known how many schizophrenic patients today will need long term hospital admission in spite of the modern treatment as tranquillizing drugs were only introduced in 1953. 223

“The treatment of chronic schizophrenia is a more complex problem. Social and rehabilitative measures are of great importance, while tranquillizing drugs are also of value. It has been found that schizophrenic patients discharged from hospital often do best at a hostel or in lodgings, rather than living at home with their parents. Disruptive emotional problems are more likely to occur at home and the family doctor may have to help the parents accept this. Work is of the greatest importance in the rehabilitation of the chronic schizophrenic. Sheltered workshops are available in some centres, but work in the community no matter how menial or monotonous the job may appear to the parents, must be actively encouraged.” (p.132)

Although this psychiatric handbook says that admissions should be “as brief as possible” the passage on treatment gives some indication of why recovery was, in the 1980s and is, 20 years later, slow and uncertain:

“In hospital, the treatment of the illness usually involves treatment with tranquillizing drugs and sometimes a short course of E.C.T. along with general social rehabilitative measures. E.C.T. is usually given 2 or 3 times a week for 6-8 treatments – its effect on schizophrenic illness is often to diminish the intensity of delusional and hallucinatory activity. These symptoms will return however unless medication with tranquillizing drugs is also commenced…Medication must be continued once the patient leaves hospital for several years in the majority of cases.” (p.131)

Continuing these drugs for several years is, of course, likely to cause permanent brain damage in the form of tardive dyskinesia (TD). This is mentioned under “side effects and their management” in the same book, but no admission is made that the condition is often permanent or that it is caused by brain damage. In fact it is described, along with akathisia, parkinsonism, dystonias and akinesia as a component of “the extrapyramidal syndrome”, the symptoms of which, the book falsely claims, “are reversed by stopping the tranquillizer or adding anti-parkinsonian drugs”. Furthermore, the book claims, again in contradiction with the information from the companies that market the drugs, that the 224

symptoms can be prevented. This, it says, can be done by either using thioridazine (“that does not usually produce this syndrome”), “by increasing dosage of drugs slowly and perhaps giving them in one dose per day” or “by giving anti-parkinsonian drugs with the tranquillizer”.

Thioridazine, marketed in Australia by Sandoz pharmaceuticals as “Melleril” is, like chlorpromazine and haloperidol, a dopamine-blocker, and can cause both parkinsonism and tardive dyskinesia, although the company claims that these are “relatively infrequent”. Anti-parkinsonian drugs are known to often worsen the symptoms of tardive dyskinesia, although paradoxically the syndrome can appear when the drugs are stopped (referred to as ‘masking’ of TD, which can also occur if the dose of the offending dopamine-blocker is increased or another dopamine-blocker substituted or added).

These problems would be avoidable if psychotherapy, including talk therapies were to be successful in resolving schizophrenia. If genuine mental health were to be promoted in the community, by what might be regarded as “public psychotherapy”, could not schizophrenia be prevented? Professor Brian Davies claimed, in 1981, that “no preventative measures are at present possible” regarding schizophrenia, stating also that “most schizophrenic and severely depressed patients are not candidates for psychotherapy” (p.58). Why should this be so? The answer becomes clear when one reads what types of “psychotherapy and behaviour therapy” he was familiar with and advised against for the treatment of schizophrenia. Confusing healing psychotherapy with Freudian psychoanalysis, he writes:

“Patients referred for psychotherapy are usually seen by the therapist on several occasions before a decision is taken to embark on formal treatment. Such treatment then means the patient will be actively involved with the therapist for a 50 minute session, once, twice, or three times a week, for several months. In formal psychoanalysis the patient may be seen five days a week for several years in this way. The methods of psychoanalysis developed by Freud are those of free association on the part of the patient and interpretation by the analyst of preconscious and unconscious material. The analyst also relies extensively on interpretations of the patient’s resistances and of the transference situation. This transference relationship is 225

encouraged by the structure of the analytic interview which is standardized. The patient lies on a couch to promote relaxation, free association and the production of unconscious material. The analyst sits out of the patient’s vision in order to minimize the inhibition of free association. The relationship between the analyst and the patient is restricted to the analytic sessions and any social contact is avoided. Because of expense and availability of analysts’ time, this form of treatment can involve only a relatively small number of psychiatric patients.” (p.58)

Apart from expense, one must also ask about effectiveness. Daily therapy for several years, while suiting the bank balance of analysts, can hardly be described as effective. The reasons for this are apparent from the specific techniques developed by Freud, their subsequent modification by psychoanalytical psychiatrists, and the assumptions involved in these techniques. Assumptions which influence the therapeutic effectiveness of psychoanalysis include those by which dreams, free associations and the verbal expressions of the patient are interpreted, and what the analyst assumes about humanity and the world we live in. An analyst with a negative view of humanity or a pessimistic attitude towards the future is unlikely to be a healing influence on those who turn to them for analysis and advice.

“Transference” is a phenomenon that was described by Freud as an inevitable consequence of psychoanalysis. Professor Davies explains that “the feelings which the patient develops toward the therapist often mirror his childhood reactions to his parents, and are regarded as being a transference from parents to therapist”. He claims that “the unskilled psychotherapist will not recognise these transference situations nor his own emotional reactions to the patient (counter-transference)”, and so “increase the problems of treatment”. He claims that “psychotherapists are usually psychiatrists who have spent several years training in psychotherapy, and this training ensures that these transference problems can be dealt with for the patient’s benefit”. A doctor who is not a psychiatrist, the psychiatry professor states, “should limit his ‘psychotherapy’ to interested listening, environmental manipulation, explanations, reassurance, advice, persuasion and re-education” and “should not uncover dynamic material by free association or dream analysis or give interpretations”. 226

The use of parentheses in the description of interested listening, explanations, advice etc as ‘psychotherapy’ gives an indication that Professor Davies did not regard such “supportive psychotherapy” as of equal merit to “psychoanalytical psychotherapy” or “behaviour therapy”, or even as genuine psychotherapy (he uses the term “psychotherapy proper” when claiming the inappropriateness of psychotherapy for the treatment of schizophrenia). One can detect in his handbook more than a hint of professional elitism and territorialism. He seems blind to the fact that what he calls “supportive psychotherapy” is much less likely to cause harm than the treatments he recommends, and has enormous therapeutic potential if done well.

The synonymous use of the words “illness”, “abnormality” and “disorder”, and the way the phrase “mental health” is freely substituted for “mental illness” is revealed in preface of the 1997 Australian Bureau of Statistics publication Mental Health and Wellbeing Profile of Adults, Australia:

“This publication presents selected results from the National Survey of Mental Health and Wellbeing in Australia, conducted from May to August 1997. Summary information is included on the prevalence of selected mental disorders, the level of disability associated with these disorders, and health services used and help needed as a consequence of a mental health problem for Australians aged 18 years or more.”

The report, which is a statistical presentation of psychiatric treatment in Australia rather than a report on mental health and wellbeing, contains 8 graphs and 23 tables of figures, together with two appendices and a glossary. The survey on which the report is based was part of the multimillion-dollar National Mental Health Strategy, the professed aims of which are:

1. To promote mental health of the Australian community

2. “Where possible”, prevent the development of mental health problems and mental disorders 227

3. Reduce the impact of mental disorders on individuals, families and the community

4. Assure the rights of people with mental disorders.

The report, available to the public for $22.00, is based on a survey of 10,600 Australians who agreed to participate after 13,600 private dwellings in all States and Territories were approached. One person over the age of 18 from each dwelling was invited to participate and the response rate was a high 78%. For unspecified reasons, the survey collected information only on “anxiety disorders”, “affective disorders”, “alcohol use disorders” and “drug use disorders”, which are described as “a range of major mental disorders”. Schizophrenia is not mentioned and is conspicuous by its absence. Six categories of “anxiety disorder” and five of “affective disorder” were surveyed and statistically presented in the report. The anxiety disorders included “panic disorder”, “agoraphobia”, “social phobia”, “generalised anxiety disorder (GAD)”, “obsessive-compulsive disorder (OCD)” and “post-traumatic stress disorder (PTSD)”. The five “affective disorders” were “depression”, “dysthymia”, “mania”, “hypomania” and “bipolar affective disorder”.

The introduction of the report does briefly refer to mental health, but immediately turns to a discussion of mental health problems and the diagnosis of “mental disorder”:

“Mental health relates to emotions, thoughts and behaviours. A person with good mental health is generally able to handle day-to-day events and obstacles, work towards important goals, and function effectively in society. However, even minor mental health problems may affect everyday activities to the extent that individuals cannot function as they would wish, or are expected to, within their family and community. Consultation with a health professional may lead to the diagnosis of a mental disorder.” (p.1)

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About the techniques by which they attempted to “measure mental health”, the report provides this explanation:

“Measuring mental health in the community through household surveys is a complex task as mental disorder is usually determined through clinical diagnoses. For the SMHWB [Survey of Mental Health and Wellbeing of Adults] the diagnostic component of the interview was administered through a modified version of the CIDI [Composite International Diagnostic Interview]. This is a comprehensive interview for adults which can be used to assess current and lifetime prevalence of mental disorders through the measurement of symptoms and their impact on day-to-day activities. The World Health Organization (WHO) Training and Reference Centre for CIDI (The WHO Centre) in Australia, contracted by HFS [Commonwealth Department of Health and Family Services], developed a computerised version of the CIDI for the SMHWB.” (p.2)

The “summary of findings”, based on these computerised assessments of the mental health of Australians, claims:

“Many Australian adults enjoy good mental health. Nevertheless almost one in five (18%) had a mental disorder at some time during the 12 months prior to the survey. The prevalence of mental disorder generally decreased with age. Young adults aged 18-24 years had the highest prevalence of mental disorder (27%), declining steadily to 6.1% of those aged 65 years and over.” (p.5)

It is difficult to see how this survey contributes to the commendable aims of the Mental Health Strategy as listed in the report, or helps remedy the problem identified in the conclusion of the Human Rights and Equal Opportunity Commission (1993) that “people with a mental illness are among the most vulnerable and disadvantaged in our community; they may experience stigma and discrimination in 229

many aspects of their lives”, which is mentioned in the report at the beginning of the “summary of findings”.

The World Health Organization, the international health arm of the United Nations was contracted by the Commonwealth Government of Australia to develop a computerised version of the “Composite International Diagnostic Interview” (CIDI) for the National Survey of Mental Health and Wellbeing of Adults, which, presumably, the taxpayers of Australia paid for. This is of concern given the contents of the 1995 WHO handbook The Management of Mental Disorders: Volume 2, Handbook for the Schizophrenic Disorders, produced by the “Training and Reference Centre for CIDI”. Distributed by the Belgian drug company Janssen-Cilag, which coincidentally markets Haldol injections for the treatment of schizophrenia, the manual contains a potentially disastrous “brief psychiatric rating scale” (BPRS) which it claims is “a widely used and easy to administer rating scale appropriate for symptom monitoring among individuals with schizophrenia”. (p.21)

Administering the BPRS involves asking the patient a series of questions and rating the presence of 24 “symptom constructs” from 1 (not present) to 7 (extremely severe). No caution is suggested regarding putting thoughts into people’s head or the influence of the questions on the diagnoser or the diagnosed. The 24 “symptom constructs” are: somatic concern, anxiety, depression, suicidality, guilt, hostility, elated mood, grandiosity, suspiciousness, hallucinations, unusual thought content, bizarre behavior, self-neglect, disorientation, conceptual disorganization, blunted affect, emotional withdrawal, motor retardation, tension, uncooperativeness, excitement, distractibility, motor hyperactivity, mannerisms and posturing.

The BPRS suggests that rating 2 “self neglect” if “hygeine/appearance” is “slightly below usual community standards” giving the examples of “shirt out of pants, buttons unbuttoned, shoe laces untied, but no social consequences”. It instructs that the following questions should be asked: 230

“How has your grooming been lately? How often do you change your clothes? How often do you take showers? Has anyone (parents/staff) complained about your grooming or dress? Do you eat regular meals?”

Moderate (rating 4) self-neglect is to be recorded if the health worker suspects “irregular eating and drinking with minimal medical concerns and consequences”. (p.14)

“Depression” in schizophrenics can, according to the BPRS, be uncovered by the following questions:

“How has your mood been recently? Have you felt depressed (sad, down,

unhappy, as if you didn’t care)?”

“Are you able to switch your attention to more pleasant topics when you

want to?”

“Do you find that you have lost interest in or get less pleasure from

things you used to enjoy, like family, friends, hobbies, watching TV,

eating?”

“Suicidality” can be elicited by: 231

“Have you felt that life wasn’t worth living? Have you thought about

harming yourself or killing yourself? Have you felt tired of living or as

though you would be better off dead? Have you ever felt like ending it

all?”

“Guilt” is rated after asking these questions:

“Is there anything you feel guilty about? Have you been thinking about

past problems?”

“Do you tend to blame yourself for things that have happened?”

“Have you done anything you’re still ashamed of?”

It is easy see the dangers of leading questions such as those given in the BPRS to detect “suspiciousness”:

“Do you ever feel uncomfortable in public? Does it seem as though

others are watching you? Are you concerned about anyone’s intentions

toward you? Is anyone going out of their way to give you a hard time, or 232

trying to hurt you? Do you feel in any danger?”

“Blunted affect” is described in the BPRS as “restricted range in emotional expressiveness of face, voice, and gestures” ranging to “marked indifference or flatness even when discussing distressing topics”. With a grotesquely comic lack of insight into normal reactions to silly questions the manual advises:

“Use the following probes at end of interview to assess emotional responsivity:

“Have you heard any good jokes lately? Would you like to hear a joke?”

The BPRS demonstrates that humanity cannot be programmed into people. Genuine interest and empathy combined with a desire to help and preparedness to listen are far more likely to relieve mental distress that a series of questions designed to ‘elicit evidence’ of ‘mental disorder’. Furthermore, giving health workers a list of questions such as these demonstrates a fundamental lack of faith in the workers to think for themselves in a compassionate and humane way. It could be argued that mental illness, or illhealth, is not necessarily abnormal in the sense that in some ways the majority may be unwell. If thinking for oneself is regarded as healthy and submissive acceptance of doctrine unhealthy, it may be that only a small proportion of the population is truly mentally healthy. If generosity is to be regarded as healthy and greed unhealthy, honesty healthy and dishonesty unhealthy, or friendliness healthy and aggression unhealthy, massive changes will need to be made to the terminology and concepts of the psychological, psychiatric and medical professions, including a fundamental revision of concepts regarding normality and abnormality, health and illness, disorder and order.

The concept of ‘disorder’ is also fraught with danger, especially if taken literally, as it often is with schizophrenia and mania. A commonly mentioned ‘sign of schizophrenia’ is disorganization: 233

disorganized thoughts, disorganized speech and disorganized behaviour. This is blamed for the ‘downward social drift’ which is said to accompany the chronic illness, along with the ‘negative symptoms’. How organized should one’s thoughts be? Should they always follow each other linearly in a logical way? If so, just about everyone has disorganized thoughts at times. In fact people spend much time sorting out confusing and contradictory information, while experiencing an inner world of thought which, although logical at times, is frequently not so. Our stream of thought is constantly interrupted and changed by new information coming into our brain from our sense organs. If this is chaotic, our thought processes also become chaotic. This need not be unpleasant nor is it necessarily unhealthy: people enjoy many chaotic experiences which can be exciting, even thrilling. The point is that ‘disorder’ in thinking often reflects disorder in the surrounding environment.

The term ‘disorder’ is more often used as a synonym for “illness”, “disease” or “abnormality”, rather than literal ‘disorder’ in the sense of disorganization. The suffix “disorder” follows many of the newly named and renamed labels contained within the American Psychiatric Association’s DSM IV, including Conduct Disorder, Attention Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, Obsessive- Compulsive Disorder, Bipolar Affective Disorder, etc. The textbook itself is a manual of “disorders”, with no cause or treatment suggested for them. It says, in other words, for what behaviours the labels should be applied but not what can be done about it.

How then can psychiatric terms and psychological terms be used to help people instead of causing chronic states of mental illhealth? How can “delusions” be most accurately defined? How can psychosis be accurately defined? How can such terms be used to aid in recovery and cure? How can they be applied objectively but compassionately? How can they be used in a way consistent with the Hippocratic Oath, which I, like most modern doctors of medicine, was never asked to swear, but assume an obligation to? How can the different meanings given to the same term, changing definitions with time, and public and professional misconceptions about psychiatric terminology be reconciled? In an effort to sort out the confusion I have attempted to be both literal and holistic, and to abide by the Hippocratic Oath and the premise of “first doing no harm”. By ‘holistic’ I mean looking at the whole: 234

the whole person and the whole meaning of words. I have tried to look at the broader meaning and the deeper inferences within the words used by the medical and psychological professions, as well as some of the equivalent or derivative terms used colloquially and by the scientific and non-scientific press. In the ensuing discussion the psychiatric illness termed “schizophrenia” will be particularly focused on as the most frequently diagnosed “psychotic” or “delusional” illness.

235

PERSECUTION IN THE GUISE OF PSYCHIATRY: SOVIET AND NAZI EXAMPLES

It is historically evident that delusions can be shared, and that people have, over the years, been persecuted for refusing to accept shared delusions. For hundreds of years most people, at least in Europe, believed the Earth to be flat. We now know this to be a shared delusion. If, in the year 1400AD, a lone voice proclaimed that the Earth was spherical, and “reality” was defined by majority beliefs or “expert opinion” the dissident thinker who believed the Earth to be spherical would have been regarded as deluded. During the period that the Christian Church maintained the dogma that the Earth is flat, people were viewed as such and consequently persecuted for their ‘heretical’ views. It is common knowledge that Renaissance scientists who agreed with Copernicus that the Earth rotated around the sun (contrary to the doctrines of the Church) were systematically persecuted for their (correct) beliefs in the Inquisition. During the 1500s and 1600s many thousands of people were killed for having beliefs unacceptable to the Catholic Church, this being done in a most “unchristian” way: by burning people alive, drowning them and executing them after various forms of torture (often in an effort to extract a ‘confession’). The men, women and children who were killed in the name of the Christian religion and God were accused of being heretics, witches, sorcerers, blasphemers, and agents of Satan.

The Spanish Inquisition began in 1478 when King Ferdinand and Queen Isabella of Spain obtained the consent of Pope Sixtus IV to appoint inquisitors for their growing empire. These were “priests” who acted as judges with the authority to order the most cruel tortures and executions, ostensibly to test “Christian faith”. During the first twenty years of the Inquisition thousands of men and women were burned alive at the stake. These people were said to have been “relaxed”, while others were “reconciled” by such penance as whipping themselves publicly and the payment of heavy fines after confessing their “errors” (Burne, 1991, p.444). Were the people who were punished and killed in this way deluded, or were the inquisitors deluded? Which were more evil: the torturers or the tortured?

236

Although the Spanish Inquisition was notable for its cruelty, intolerance and long duration, the persecution of people with dissident views has a far longer and wider history than that of the Catholic Church’s efforts to suppress criticism of its doctrines and activities, and neither did it end with the formal cessation of the Inquisition. Such persecution has been implemented by religious as well as political organizations and institutions, and it has also occurred within corporations, educational institutions, cultures and families. This persecution of people with dissident views may be ‘informal’ (as in intolerant families) or highly formalized (and organized) as in the diagnosis of “sluggish schizophrenia” in the Soviet Union during the 1950s, 60s and 70s.

The Australian psychiatrist Sidney Bloch revealed, in his March 1996 Beattie Smith lecture at the University of Melbourne, the misuse of psychiatric labels by Communist Russia to persecute political dissidents. The lecture was published in the Australian and New Zealand Journal of Psychiatry in 1997 and tells of the celebrated career of Professor Andrei Snezhnevsky who developed the theoretical framework by which critics of the State could be systematically persecuted:

“A particular form of the disease, sluggish schizophrenia, accounted for the much wider limits placed on the use of the concept, named so because its rate of progression was so slow. Typically, patients given this label were purportedly able to function almost normally. Their symptoms might resemble those of a neurosis or take on a paranoid quality including grandiose ideas of reforming society; the latter feature was to prove a handy means for the State to enlist psychiatry to pursue its political purposes.” (p.174)

Professor Bloch gave details of how Professor Snezhnevsky altered the Russian medical profession’s beliefs about “schizophrenia” to suit the Soviet Government’s political agenda. These have much relevance today, since similar alterations also occurred outside the Soviet Union:

“In essence, he devised concepts which profoundly shifted the way the condition was used clinically. This was no mere academic exercise. Several crucial repercussions eventuated: (i) 237

schizophrenia was always genetically determined; (ii) although its features might only manifest intermittently, the biological foundation of the illness always remained; (iii) recovery was not possible; (iv) the main question was the speed with which the patient would deteriorate; and (v) rather sinisterly, because the illness might present with mild symptoms and only progress later, schizophrenia was much more common than previously thought.” (p.174)

Professor Bloch also drew attention to the involvement of the psychiatry fraternity in the German Nazi genocide of the 1930s and 40s during the rule of Adolf Hitler. He told of the compulsory sterilization of those diagnosed with schizophrenia and manic-depression, of the “racial hygeine policy” that included the “euthanasia” of the mentally ill and intellectually retarded, and of the “final solution”: the mass-murder of “valueless life”, including Gypsies, Jews and homosexuals. He reminded the audience that prominent and highly regarded academic psychiatrists were involved the development and implementation of the “eugenic” mass-extermination popularly and historically known as the “Holocaust”. These included Professor Alfred Hoche who regarded the mentally ill as “absolutely worthless human beings” for whom he advocated “urgent death”, and Professors Ernest Rudin and Werner Heyde, who played prominent roles in the sterilization campaigns and mass-exterminations which followed. Professor Kurt Schneider of Heidelberg, who is still venerated as the definer of the “first rank symptoms of schizophrenia” was a Nazi Party stalwart who “contributed energetically to the euthanasia program”, according to Professor Bloch.

Interestingly, given the two examples Professor Bloch (who is Jewish) gives of psychiatric abuses (the Soviet Union and Nazi Germany), he fails to mention that the Nazis also “euthanased” communists, or that eugenic sterilization laws advocating, for example, the castration of boys, were introduced and implemented in several states of the USA as early as the turn of the twentieth century. This failure to mention the political as well as the racial aspects of Nazi ‘eugenic’ programs obscures the ideological, ontological and historical connections between the Russian and German examples. It also makes it more difficult to see the relevance of these terrible events to modern psychiatry in the “free world”, including the USA, Canada, Europe, New Zealand and Australia. The society in which Professor Bloch 238

has worked for many years as a senior psychiatrist prides itself as being part of the “free world” and the governments of Australia declare this to be a democratic as well as a free and peaceful nation. Thus, when Foundations of Clinical Psychiatry, of which Professor Bloch is co-editor, declares that “delusional explanations for novel subjective experiences in which the person’s mind or body seems to be influenced by external forces” are characteristic of (true) schizophrenia, a question that might reasonably be asked is: “has the concept of schizophrenia been politically doctored in the ‘capitalist world’ as it was in the ‘communist world’ and by the Nazi regimes?”

The belief that one’s mind is controlled by external forces is regarded by modern American and Australian psychiatry as being abnormal and indicative of mental serious illness described as both psychotic and delusional. The American Psychiatry Association’s DSMIV states:

“Delusions that express a loss of control over mind or body (i.e., those included among Schneider’s list of “first-rank symptoms”) are generally considered to be bizarre; these include a person’s belief that his or her thoughts have been taken away by some outside force (“thought withdrawal”), that alien thoughts have been put into his or her mind (“thought insertion”), or that his or her body or actions are being acted on or manipulated by outside force (“delusions of control”). If the delusions are judged to be bizarre, only this single symptom is needed to satisfy Criterion A for Schizophrenia.” (p.275)

Kurt Schneider (1887-1967), previously mentioned as a German psychiatrist who participated in the forced sterilization and mass-murder of those, including the “mentally ill”, regarded by the Nazis as “degenerate”, described, in 1959, eleven “symptoms” each of which he regarded as ‘pathognomonic’ (exclusively and specifically diagnostic) of schizophrenia. These were, as described in E. Fuller Torrey’s Surviving Schizophrenia:

1. Auditory hallucinations in which the voices speak one’s thoughts aloud 239

2. Auditory hallucinations with two voices arguing

3. Auditory hallucinations with the voices commenting on one’s actions

4. Hallucinations of touch when the bodily sensation is imposed by some external agency

5. Withdrawal of thoughts from one’s mind

6. Insertion of thoughts into one’s mind by others

7. Believing one’s thoughts are being broadcast to others, as by radio or television

8. Insertion by others of feelings into one’s mind

9. Insertion by others of irresistible impulses into one’s mind

10. Feeling that one’s actions are under the control of others, like an automaton

11. Delusions of perception, as when one is certain that a normal remark has a secret meaning for oneself.

These “symptoms”, though now not regarded as “pathognomonic” (distinctive and conclusive evidence) of schizophrenia, remain prominent among the reasons young people are diagnosed as schizophrenic or manic in Australia, Europe and America today. It seems remarkable that a man who is recognised as a proponent of mass-murder could continue to be venerated and respected for his views on what constitutes schizophrenia. It is also of note that most texts that mention Schneider’s first rank symptoms do not mention his earlier involvement in the Nazi extermination program. 240

The Canadian medical historian Edward Shorter, in A History of Psychiatry describes Schneider as “one of the great modern investigators of schizophrenia”, but fails to mention what, exactly, he discovered. Michael Stone, in Healing the Mind gives the following account of the Heidelberg professor’s work:

“Another German, Kurt Schneider (1887-1967), wrote an important treatise on “psychopathic personalities” (1923), by which he meant abnormal, not antisocial variants. His characterology was “atheoretic” – that is, it was not tied to any assumptions about etiology – unlike Kraepelin’s “temperaments,” which he saw as attenuated forms of manic-depression. Although Schneider used a different set of terms, there are close correspondences between his typology and the personality disorder labels in current use. Thus Schneider’s “insecure” type, with its two subtypes of “sensitive” and “anankastic,” correspond to our “dependent” and “obsessive”; his “fanatic” is like our “paranoid”; his “attention-seeking” like our “hysteric.” Persons we now distinguish as “psychopathic/antisocial” were “affectionless” in Schneider’s terminology.

“Later (1959), Schneider would enumerate some eleven symptoms he felt were pathognomonic of schizophrenia. His first-rank symptoms included “thought aloud,” “thought insertion,” “thought broadcast,” and “hallucinations where the patient hears voices describing his activity as it takes place.” (p.148)

E. Fuller Torrey does not mention Kurt Schneider’s Nazi past in Surviving Schizophrenia, describing him as “a German psychiatrist” before listing his “first rank symptoms”. Torrey, an American psychiatrist, admits some discordance between the USA and Europe regarding the application of schizophrenia label, and refers to the Soviet abuses although he does not detail them:

“These symptoms [Schneider’s list] are commonly used in European countries as grounds for the diagnosis of schizophrenia, although less so in the United States. Studies have shown that at least three-quarters of schizophrenic patients have one or more of these symptoms. However, they cannot be considered as definitive for the disease because they are also found in at least one-quarter of patients with manic-depressive illness. 241

“Until recently, the term “schizophrenia” was used much more loosely and broadly in the United States than in most European countries. In fact the only other country in the world where schizophrenia was diagnosed just as loosely was in the Soviet Union, where it has been abused as a label to discredit and stigmatize opponents of the government.” (p.46)

Dr Torrey, who worked as a Special Assistant to the Director of the National Institute of Mental Health from 1976 to 1984, claims that “American psychiatry took a major step forward in 1980 when it adopted a revised system of diagnosis and nomenclature and issued it in the third edition of the Diagnostic and Statistical Manual of Mental Disorders”. He lists the (then) new criteria (which can be compared with the criteria from the DSM IV, previously described):

1. Symptoms of illness have been present for at least six months

2. There has been some deterioration of functioning from previous levels in such areas as work skills, social relations, and self-care

3. The disease began before age 45

4. The disease symptoms do not suggest organic mental disorders or mental retardation

5. The disease symptoms do not suggest manic-depressive illness

6. At least of one of the following symptoms is present:

a. Bizarre delusions where the content is patently absurd and has no possible basis in fact, such as delusions of being controlled, thought insertion, thought withdrawal, and thought broadcasting 242

b. Delusions of a grandiose, religious, nihilistic, or somatic nature if ideas of persecution or jealousy are absent

c. Delusions of persecution or jealous content if accompanied by hallucinations of any type

d. Auditory hallucinations in which a voice comments on the person’s behavior or thoughts or two or more voices converse with each other

e. Auditory hallucinations heard on several occasions with more than one or two words and having no apparent relation to depression and elation

f. Marked loosening of associations, markedly illogical thinking, incoherence, or marked poverty of speech if associated with either blunted or inappropriate affect, delusions, hallucinations, catatonia, or grossly disorganized behavior

The wording of criterion 6(a) is important. The inference is than any belief in thought control, insertion, withdrawal or broadcasting is delusional, “patently absurd” and “bizarre” (not that only patently absurd or bizarre beliefs about these things should be regarded as delusional). This is an important semantic difference, and the literal application of criterion 6(a) designates much of the population as “schizophrenic” and presents extraordinary opportunities for thought control of the public. This becomes evident when “delusions of being controlled, thought insertion, thought withdrawal and thought broadcasting” are examined more closely.

“Delusions of control” and other delusions are inferred primarily from what a patient says, which, it is presumed, represents what the person believes. This is not necessarily a valid assumption, since patients, by virtue of the power imbalance in the doctor-patient (or nurse-patient) relationship, may say 243

what they think is expected of them or least likely to cause offence. People also express their beliefs about “control” differently, depending on their actual beliefs, but also on their vocabulary, their turn of phrase, and the questions they are asked. It is because of the latter that it is important to not ask leading questions if one wishes to understand what a person really thinks. It is common knowledge that one can “put words in someone’s mouth”, and one can “give someone ideas”. One must question, then, the teaching that Australian medical students receive in Foundations of Clinical Psychiatry on how to “elicit delusions”:

“In eliciting delusions, it is useful to first ask a question which should elicit a positive response from anyone, and then to probe further for abnormal thought content. For instance: ‘Do you ever feel self-conscious or shy in a new place or with strangers?’ The answer should be ‘yes’ if the question was understood. Then the patient can be asked whether they worry if people laugh behind their back, and so on, progressing to ask about organised persecution.” (p.74)

An effective way of inducing rather than ‘revealing’ paranoia. This passage, from a chapter titled “the psychiatric interview and evaluation of the mental state” was authored by Melbourne psychiatrist Nicholas Keks, Professor of Hospital and Community Psychiatry at the Alfred Hospital and Monash University, who was earlier quoted as admitting that dopamine-blockers can aggravate the “negative symptoms” of schizophrenia (but not in this textbook).

244

RESEARCH ON DEAD MENTAL PATIENTS IN AUSTRALIA

The Alfred Hospital is in the Inner East of Melbourne and injects many members of the public, mainly young people, with dopamine-blockers, often against their will. The commonest labels given to the hospitals involuntary patients are “schizophrenia”, “schizoaffective disorder”, “hypomania” and “mania”. Some are said to have “personality disorders” and many are regarded as “drug addicts”. Many have been given several different psychiatric labels by different psychiatrists at different times. Some of the people in the psychiatric wards of the Alfred Hospital have been diagnosed as being depressed; most of these are there voluntarily. This is not the case for most of those diagnosed with “schizophrenia”, “hypomania” or “mania”. These people are said to be notorious for “lack of insight”, “lack of compliance” and “tendency to abscond”: in other words, they refute the diagnosis, refuse the drugs and try to escape.

Professor Keks, who is also director of psychopharmacology at the Mental Health Research Institute (MHRI) in Parkville, Melbourne, was one of the authors of a revealing article published in the Australian and New Zealand Journal of Psychiatry in 1998 titled “Confirmation of the diagnosis of schizophrenia after death using DSM-IV: a Victorian experience”. Co-authored by Susan Roberts and Christine Hill (psychologists), Professor David Copalov (Director of the MHRI), and Ken Opeskin of the Victorian Institute of Forensic Medicine, the paper described their “method” as follows:

“Between 1990 and 1994, samples of brain tissue from subjects with a recorded diagnosis of schizophrenia were collected. The diagnoses within the police records were based on information received from medical records, clinicians and relatives. In this study, the case histories from 83 subjects (56 males, 27 females) were reviewed. The males were aged between 18 and 83 years (mean age = 42.9 years), while females were aged between 20 and 81 years (mean = 47.4). Forty-seven (56.6%) of the 83 subjects had committed suicide (males, 55.3%; females, 51.8%). The mean age of suicide for males was 31.7 years compared to 34.0 years for 245

females, whereas the mean age for the non-suicide group was 56.7 years for males and 61.9 years for females.

“The case histories of all 83 individuals were independently reviewed by a psychologist (CH) and a psychiatrist (NK). In cases where the two raters did not reach a consensus diagnosis, discussion occurred and a final diagnosis was agreed upon. To facilitate the standardised extraction of the relevant clinical and demographic information from the histories, a systematic assessment process based on a semi-structured chart review, the Diagnostic Evaluation After Death (DEAD), was used. The DEAD [13] could not be used in its entirety because it only permits the generalisation of diagnoses according to Feighner [14], DSM-III [15] and RDC [16] criteria. Thus, additional information was collected to allow the classification of cases according to DSM IV, as had been done previously for DSM-III-R and ICD-10 criteria.” (p.75)

The methodology of this study reveals much about the mental illness research industry, a multi-billion dollar global enterprise whose stated objective is to discover the cause and cure of mental illness. This industry, centred in major cities around the world, is remarkably complex, and increasingly lucrative. It receives funding though government bodies, private organizations and public donations. In Australia much of the direct funding for the mental illness research industry from the government in allocated by the National Health and Medical Research Council (NHMRC). This study acknowledges the financial support of the NHMRC Brain Network for Research into Mental Disorders.

“Confirmation of the diagnosis of schizophrenia after death using the DSM-IV: a Victorian experience” presents a dehumanized statistical analysis of retrospective re-classification of 83 people who had “a provisional diagnosis of schizophrenia at autopsy”. Using the American Psychiatric Association’s DSM IV, the authors re-examined the dead patients’ case records (hospital charts and maybe outpatient clinic records) and came to a retrospective diagnosis based on the (then) new DSM criteria. The retrospective label was reached by consensus between Professor Keks and Christine Hill, (if they failed to agree when examining the charts independently) and compared with “previously obtained diagnoses 246

using DSM-III-R and ICD-10 criteria”. They found that, according to the DSM IV criteria, 30.1% of the presumed schizophrenics did not have schizophrenia, compared to 36.1% using DSM III-R (the previous edition of the manual, published in 1987) and 51.8% using the ICD-10 (the World Health Organization’s ‘International Classification of Disease’). They found “excellent concordance” between the DSM IV and DSM III-R, but “only fair agreement” between DSM IV and ICD 10. As they point out in the discussion, it is not surprising that they reached similar diagnoses when using subsequent editions of the same manual. They explained the closer concordance between the diagnoses in the Australians’ ‘police reports’ and American Psychiatric Association’s classification than with the W.H.O.’s thus:

“There are several possible explanations for the lower rate of misclassification found using DSM-IV criteria compared to ICD-10 criteria. In cases where the antemortem diagnosis in police reports was based on the use of standardized criteria, the difference could be due to the more prevalent use of DSM-IV or DSM-III-R criteria within Victorian psychiatric hospitals. For cases where the antemortem diagnosis was derived using DSM-IV or DSM-III-R criteria, one would reasonably expect a higher rate of mismatch when applying ICD-10 criteria to those cases post mortem. Unfortunately, we were unable to determine how many of the provisional diagnoses in the police reports reflected formal diagnoses using established criteria. An alternative explanation may be found in an examination of the diagnostic breakdown of reclassified cases. Six (24.0%) of the 25 cases with an antemortem diagnosis of schizophrenia were reassigned a DSM-IV diagnosis of schizoaffective disorder compared to the 20 (46.5%) cases when ICD-10 criteria were applied. While the ICD-10 definition of schizoaffective disorder requires the simultaneous presence and approximate balance of psychotic and affective symptoms, DSM-IV criteria specifies a distinct psychotic episode without prominent affective symptoms. At this point, we do not have sufficient information to determine which of these explanations is more likely reflected in the data.” (p.75)

There are other explanations, which become evident when the two possibilities raised by the authors are considered. This study compared the diagnosis presumed at autopsy (according to Victorian State police records) with retrospective diagnosis from “a systematic assessment process based on a semi- 247

structured chart review”. This, termed DEAD (Diagnostic Evaluation After Death), involved “the standardised extraction of the relevant clinical and demographic information from the histories”. The diagnoses reached when using the DSM IV, DSM-III-R and ICD-10 were compared for concordance with the diagnosis as stated in the police records (“ante-mortem”). The authors speculated as to whether the closer concordance of the ante-mortem diagnoses with the DSM criteria than with the ICD criteria was due to larger influence of the DSM than the ICD classification systems in Victorian psychiatric hospitals, police diagnoses not reflecting “formal diagnoses using established criteria”, or differences between the DSM and ICD classifications regarding the diagnosis of “schizophrenia” versus “schizoaffective disorder”.

In discussing this lack of concordance the term “misclassification” is used, but not the legally relevant “misdiagnosis”. The people who were “re-classified” according to their official medical records are not able to challenge their new label since they are now dead. Tragically, these people, most of whom committed suicide sometime after diagnosis and treatment, and must therefore be recognised as failures of the mental health system, are not allowed to rest in peace, nor are serious efforts made, through critically examining the treatment they were given, to find out why they died and how such deaths can be prevented. It is easy to see what a “semistructured” chart review and “extraction of the relevant clinical and demographic information from the histories” means: scanning the often illegible doctors notes for words like “paranoia”, “ideas of reference”, “delusions”, “expansive mood”, “auditory hallucinations” etc.

It is well known that the American Psychiatric Association’s DSM classification is used as the definitive labelling guide in Australian psychiatry, not just in Victoria but in other States as well. In universities and medical schools the DSM is mentioned more frequently than the ICD, as in the hospitals, clinics and both psychiatric and psychological literature. Often the DSM is quoted as an absolute authority regarding the accuracy of classification although it is also taught in Australian psychiatry that “the DSM should not be used as a cook-book”. By this it is usually meant that diagnoses which do not fulfil DSM criteria are still to be regarded as valid. In fact, the DSM and ICD 248

classifications are very similar and based on the same paradigm, and thus congruence in diagnosis using the “different systems” does not prove the validity of labels like schizophrenia, especially when applied retrospectively on the basis of selected (“extraction” of “relevant”) information.

The fact that “ante-mortem” diagnoses differed from “post-mortem” diagnoses, and that these differences were regarded as acceptable says much about how psychiatry differs from other medical disciplines. If post-mortem examination found that, say, 30 percent of people diagnosed as having lung cancer actually had cancer of the bowel (or diabetes) there would be justified accusations of medical negligence against the institutions involved. A question worth asking, which could best be answered by the authors and the Victorian Institute of Forensic Medicine, is: “if the provisional diagnoses in the police records were not based on formal diagnoses using established criteria, what were they based on, and who made them?” It would also be of interest to know how many of the 47 people who “committed suicide” did so by the self-ingestion of prescribed drugs or drugs which they were initiated into within the psychiatric or prisons systems. Further light would be shed on the subject by knowing how many of the people who died were objecting to their diagnosis and treatment, how much time they had spent in hospital, what drugs were being prescribed to them at the time of death (and by whom), how soon after diagnosis they died and what their reaction was to diagnosis and treatment. This is surely the obligation of the medical profession, coroner and the hospitals at which they were treated, and of the police, before their deaths are declared to be suicide. Mental health researchers also have much to learn through critically examining past mistakes and failures.

Further information of value in preventing such deaths could be obtained by knowing the reaction of the dead people’s families to their diagnosis and their subsequent reaction to their death. For these families, actively seeking the writings, poetry, drawings and other person expressions of the dead people would help those who did not understand these mostly young people in life, to at least understand what they were trying to say.

249

The authors of this short paper do not mention what was done with the brain tissue that was removed at autopsy, apart from the fact that “samples of brain tissue from subjects with a recorded diagnosis of schizophrenia were collected”. The discussion, which follows the “results” in the usual style of such papers mentions brain tissue again, suggesting a growing industry in human brain specimens:

“The findings of this study have immediate and important practical implications for researchers involved in studies of schizophrenia using human brain tissue. It is clear that newly developed diagnostic criteria can be applied to existing data provided sufficient information has been extracted from case histories. With the increasing number of postmortem studies, and international recognition of the need to establish central tissue banks, it will be imperative to be able to upgrade diagnoses as the new criteria are developed. To ensure this, rigorous and standardised extraction of data from case histories must become an integral component of all postmortem studies of schizophrenia.” (p.75)

Dehumanization is the great enemy of humanity, and of genuinely healing psychiatry (and medicine). It is easy to forget that these “cases” were living human beings with ideas, aspirations, loves and fears, families and friends. Becoming statistics which can be manipulated by those who failed to heal them of their distress (and significantly contributed to it) is bad enough, but on a personal level, as well as a historical one the activities described as a “research study” do a terrible disservice to the dead. Considering that many psychiatric patients actively fight against the system that would label them and treat them against their will it is a cruel injustice that this same system should be allowed to pass judgement after they die (while ignoring its own culpability). One wonders also about how many (if any) of the ‘schizophrenics’ whose brain tissue has been collected would want to have their diagnosis “upgraded”, rather than the genuine causes of their death understood.

The issue of social control is a fundamental one in psychiatry, which is inadequately discussed by the medical profession. The opinions of “dissident psychiatrists” such as Peter Breggin and Thomas Szasz are routinely denigrated and dismissed by the hospital and university based psychiatrists who supervise 250

the forced treatment of the public in various countries. These universities and hospitals are mainly in large cities, and a destructive competition for status occurs between hospitals and universities for status, although collaboration occurs between cities, hospitals and universities in the development and implementation of “public health programs”, including those relating to “mental health” and the treatment of the “mentally ill”. It is consequently an undemocratic and elitist system that decides what is normal and acceptable behaviour of the public, and then implements treatment of those who do not “come up to standard”. This phenomenon occurs around the world, however the detailed socio-political systems vary between nations. In Australia, hospital-based treatment of the public occurs in public hospitals and private psychiatric hospitals. No details of the treatment given in these hospitals is provided to the public, and people who have been forcibly treated are able to see what has been written about them only by appealing through Freedom of Information (FOI) requests. Often the request is refused because the information is judged by the treating psychiatrist or hospital to be “potentially damaging to the patient”. It takes little cynicism to see how this clause could be misused.

The treatment of the public in Victoria, where the “confirmation of the diagnosis of schizophrenia after death” study was performed, is implemented by public hospital-based teams called “CAT teams”. CAT stands for “Crisis Assessment and Treatment” and the teams are under the authority of psychiatrists. Professor Nicholas Keks is currently in charge of the CAT team based at the Alfred Hospital, which is allied with Monash University in South Eastern Melbourne. Monash University and the University of Melbourne, north of the Yarra River, are the only universities with medical schools in the State of Victoria. Aspiring doctors from rural areas of Victoria are obliged under the present system to come to the State’s capital city, Melbourne, to acquire a medical degree. In the city they learn how to diagnose mental illness according to criteria developed by men in European and American cities many decades ago. The CAT teams implement this diagnosis and treatment at the frontline: team members go in cars, usually in pairs, and visit people “in the community”. Most of these people do not welcome the visit, partly because of the obsession of CAT teams with ensuring “compliance”, and partly because the teams have the power to recommend their incarceration and arrange it, with police assistance, if necessary. They consider themselves legally authorised to break into people’s houses with local police and take them away merely for the suspicion of “non-compliance”. Ironically, most CAT team members, most of whom are psychiatric nurses, social workers or ‘clinical psychologists’ genuinely 251

believe that their “clients” who hide behind closed shutters are paranoid, rather than hiding from their unwelcome attentions.

Compliance with psychiatric treatment is ensured in Australia through “Community Treatment Orders” (CTOs), which can only be legally made by qualified psychiatrists. These make people ‘involuntary patients’ of the State psychiatric system (centred in the public hospitals, from which CAT teams are sent into the community). It is only public hospital-based psychiatrists who are allowed to place people on CTOs, which can be removed on order of the “Mental Health Review Board”, if this regulatory Board is convinced that legal criteria for forced treatment are not satisfied. It rarely is. Represented by teams of three (a lawyer, psychiatrist and ‘community member’), the Board holds ‘hearings’ in the same hospitals and clinics where people are being incarcerated and drugged, amounting to an inquisition, not of the treating psychiatrists, but of the ‘clients’. Over the past few years in Victoria, since the introduction of this system, fewer than 5 percent of appeals for release from forced treatment (and there are several thousand every year) have been successful. One reason for this is the general insistence of the Board that refusal to accept a psychiatric label is itself evidence of mental illness – regarded as ‘lack of insight.

252

TELEPATHY AND DIAGNOSIS OF SCHIZOPHRENIA

According to any modern psychiatric text, “thought insertion”, “thought broadcasting” and “thought withdrawal” are typical of schizophrenia: these being examples of what is termed “formal thought disorder” (FTD). At the same time a silent majority of the world's population believe in telepathy or so- called Extra-sensory perception or ESP.

Major universities if Britain, Europe, Russia and the USA have seriously studied the possibility of distant transfer of mental images and perceptions through carefully controlled scientific tests. Many of the researchers have changed from scepticism to grudging acceptance that some degree of telepathy does occur at times, though undoubtedly people ascribe coincidence to telepathy others.

Two key results emerge from this fact. Firstly, thought insertion and broadcasting are in fact descriptions of belief in telepathy and these diagnostic criteria create a paradigm in which any genuine telepathic experience will be pathologised and drugged. In fact the expression of belief in telepathy without claims to have experienced it as a transmitter or receiver can be pathologised in this way.

The second result is that telepathic connection between identical twins, of which anecdotal reports are common, will automatically be ascribed to genes rather than their real cause. Twin studies are the main basis on which the claim that schizophrenia is genetically caused is made. In these studies identical twins show far greater concordance in diagnosis of schizophrenia than non-identical twins and other siblings. This is a powerful argument, in the absence of telepathy, that supports the common view that schizophrenia is a genuine mental illness that is partly inherited. However, this view fails to consider the deeper issue of the inheritance of traits which are systematically, but inappropriately pathologised. 253

If, for example, ability to receive telepathic messages from other humans (or from animals, for that matter) are inherited to any degree, with the pathologisation of thought insertion and belief in thought broadcasting, such 'schizophrenics' will predicably show family clustering. A similar phenomenon would occur if tendency to auditory hallucinations are partly inherited, as appears, for example, to be the case with musical ability.

Many people have experienced advertising slogans they have heard on the television popping into their mind days, weeks or months later. Could this be viewed as “thought insertion”? It’s a matter of semantics.

From the time of the Inquisition, people, who heard voices in their head, especially if they spoke to them have been said to be mad or demonically possessed.

What about the systematic denigration and punishment of the opinions, beliefs and views which have been diagnosed as “delusional”? Is this genuine persecution, or are all beliefs in persecution ‘delusional’? What of the common advice given for how to deal with uncomfortable truths: “forget it”? Could this not be regarded as “thought withdrawal?” Any person who believes in telepathy or prayer believes also in “thought broadcasting” although they may believe in selective receptiveness (e.g., by “God”, Jesus or some other deity).

The belief in mass population-control by any force, governmental or otherwise, can be interpreted as “delusions of control”. Thus talk of mind control experiments by the CIA and US military, such as the notorious MK experiments, makes many medical doctors (and other health-care workers) suspect paranoia, schizophrenia or delusional disorder, as does talk of “the New World Order”, or “corporate 254

conspiracies”. The equation of the word “conspiracy” with “paranoia” is a feature of modern psychiatry, and to a lesser degree, society, which has resulted in people of all ages in modern Australia, America and Europe fearing even the discussion of conspiracies other than those revealed in the “mainstream media”. The mass-media too avoids the presentation or discussion of conspiracies, especially scientific and corporate conspiracies, despite the fact that they are of great public importance and interest.

The fact that people are afraid to talk about conspiracies and the media to report them can be guaranteed to facilitate their proliferation. Of course, people can be mistaken about conspiracies: they can be deluded and they can be paranoid, imagining conspiracies to exist where they do not. They can also be deluded about “thought insertion” and “thought broadcasting”. Take, for example a person who believes that alien thoughts are radiated into their brain from, say, Pine Gap, the American military base in Central Australia.

Such a person would undoubtedly be diagnosed as psychotic, as would a person who believed ideas were radiated into their brain from Alpha Centauri, the Eiffel Tower or anywhere else. Most people would accept that these beliefs are delusional, but what about the belief that thoughts are radiated into one’s brain from the local television or radio station, or by radio or television programmers?

In 1975, in the chapter on “Disorders of the mind”, the fourth edition of Professor John Walton’s neurology textbook Essentials of Neurology, advises physicians to suspect the delusions of schizophrenia if a patient believes “that he is being influenced by electricity or radio waves” (p.139). The 1995 WHO publication The Management of Mental Disorders, Volume 2: Handbook for the Schizophrenic Disorders states that delusions can be elicited by asking, “Is anything like electricity, X- rays, or radio waves affecting you?” The rating of “severe delusion”, according to this handbook, should be made on the basis of “much preoccupation OR many areas of functioning [being] disrupted 255

by delusional thinking”. One might think that to justify psychiatric treatment this should read “AND”, but it does not. Severe delusions can be diagnosed, according to the W.H.O., because of “preoccupation” even if functioning is not disrupted.

What then, of a person who gives up a 9 to 5 office job and decides to devote their time to studying the politics of social control, drawing attention to the dangers of nuclear radiation, and stopping the construction of a uranium mine? He would be regarded as deluded and psychotic because of his concern about radiation and showing evidence of “social and occupational dysfunction” because of his decision to quit his job. A thousand other similar examples can be given as to why people can be misdiagnosed as “mentally ill” because they change their priorities, their attitude to authority and convention or their lifestyle, their politics or religion.

The hypothetical revolutionary office worker described above would not necessarily be diagnosed as “schizophrenic”: this would depend on how he behaved and how long he maintained his dissident behaviour. Whether or not he would be diagnosed at all would depend on the reaction of his family, his employer and society itself. It would depend on how he explained his change in ideas and his change in behaviour. Supposing he did, however, due to the concern of his family or employer, come to be considered for psychiatric diagnosis (and treatment). Regardless of whether or not he felt ill he would likely be regarded as psychotic and deluded because of his current beliefs and behaviour, including his “preoccupation” with “control/radiation” and for quitting his job without having another. If his beliefs about control or radiation were regarded as “bizarre”, “absurd”, “odd”, “unusual” or “strange”, the likely diagnosis would be “schizophrenia” or perhaps “mania”. If the “delusions” were considered “non-bizarre” he would be eligible for a label of “delusional disorder”. In terms of treatment, however, there would be little difference: tablets, and if he refuses them injections, of dopamine-blockers. He would be accused of having “lack of insight” if he refuses to agree that firstly, he is “mentally ill” and secondly, that he requires “medication” for the treatment of this ‘illness’.

256

The DSM IV describes “delusional disorder” as follows:

“The essential feature of Delusional Disorder is the presence of one or more nonbizarre delusions that persist for at least 1 month (Criterion A). A diagnosis of Delusional Disorder is not given if the individual has ever had a symptom presentation that met Criterion A for Schizophrenia (Criterion B). Auditory or visual hallucinations, if present, are not prominent. Tactile or olfactory hallucinations may be present (and prominent) if they are related to the delusional theme (e.g., the sensation of being infested with insects associated with delusions of infestation, or the perception that one emits a foul odor from a body orifice associated with delusions of reference). Apart from the direct impact of the delusions, psychosocial functioning is not markedly impaired, and behavior is neither obviously odd nor bizarre (Criterion C). If mood episodes occur concurrently with the delusions, the total duration of these mood episodes is relatively brief compared with the total duration of the delusional periods (Criterion D). The delusions are not due to the direct physiological effects of a substance (e.g., cocaine) or a general medical condition.” (p.296)

The DSM IV presents seven “subtypes” of “delusional disorder”: “erotomanic”, “grandiose”, “jealous”, “persecutory”, “somatic”, “mixed” and “unspecified”. The last of these is a “catch-all”: “This subtype applies when the dominant delusional belief cannot be clearly determined or is not described in the specific types”. Of these, the “subtype” of “persecutory delusions” is of particular relevance to civil rights, politics and law:

“This subtype applies when the central theme of the delusion involves the person’s belief that he or she is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals. Small slights may exaggerated and become the focus of a delusional system. The focus of the delusion is often on some injustice that must be remedied by legal action (“querulous paranoia”), and the affected person may engage in repeated attempts to obtain satisfaction by appeal to the courts and other government agencies. Individuals with persecutory delusions are often resentful and angry and may resort to violence against those they believe are hurting them.” (p.298) 257

The term “querulous paranoia” is less commonly used in Australia than “litiginous”, but the effect is the same: people who threaten legal action against the psychiatric system or persist in seeking justice through various legal channels can be diagnosed as “seriously ill” because of their behaviour. People who accuse those who forcibly drug them with “poisoning” or “mind control” can also be diagnosed with paranoid delusions and delusions of control.

Delusions of control, paranoia and “thought disorder” can be diagnosed on the basis of many common “New Age” beliefs. A close study of Schneider’s “first rank symptoms” and the fact that they are still highly regarded by medical doctors and psychiatrists explains why people, young and old, who believe in “channeling”, “telepathy”, “clairvoyance”, “possession” and similar phenomena satisfy currently used criteria for diagnosis of the ‘delusions’ of ‘schizophrenia’ (and ‘mania’), as do people who believe in “astral travel”, “alien communication”, “reincarnation”, “transmigration of souls” and similar beliefs. These beliefs, some of which are common to ancient religious traditions (notably Animist, Hindu and Buddhist ones) have become recently popular in the context of “New Age” religions and conversions to Buddhism and Hinduism in the “West”.

Schneider’s “first rank symptoms” assume firstly, that telepathy does not occur and secondly, any belief that it does occur is evidence of mental illness. The word “telepathy” is derived from the Greek tele: afar and pathos: feeling. It is also commonly referred to as “extrasensory perception” or ESP, although this term can be misunderstood. Firstly, many things can be perceived on the basis of “internal” contemplation and insight (rather than via the senses), and secondly, the perception of others feelings from a distance may be sensorily perceived in a way presently not understood, but presumably involving parts of the brain. In 1898, more than half a century before Schneider listed various beliefs about telepathy as indicative of schizophrenia, his compatriot Dr Albert Moll wrote, in Hypnotism:

“Telepathy means the transference of thoughts, feelings, sensations &c., from a person A. to a person B. by some means other than the recognised sense perceptions of B. Consequently such 258

thought-reading is altogether excluded, in which one person guesses the thought of another by means of the tremors in his muscles, i.e., by a recognized kind of perception.” (p.399)

He goes on to describe a range of scientific experiments, some involving hypnotism (“mesmerism”) that were performed to test for telepathy and the conclusions of eminent scientists at the time:

“In making the experiments, the person B., who is to guess the thoughts of A., is often mesmerized by A., as this is supposed to make the transference easier. Some English experimenters, Guthrie in particular, have made experiments when both persons were quite awake. The transference is supposed to be caused merely by strong concentration of thought on the part of the agent. In the same way the subject feels the agent’s sense perceptions. If A. is pricked, B. feels it; if A. tastes salt, B. tastes it &c. It is also said that A. can make B. act, merely by concentrating on what B. is supposed to do. Others think that it is the concentration of A’s will on B. which causes the action. Perronnet even maintains that it is possible to influence the pulse and cause vasomotor changes telepathically, by an effort of will. The nearer A. is to B. the better, but the phenomena are said to have been observed when the subject and agent were separated by several kilometres. It is said to be even possible to hypnotise certain people at long distances by concentration of thought; such experiments are said to have succeeded at Havre. Among authors who vouch for the reality of telepathy, and whose experiments deserve consideration, I mention Charles Richet, Ochorowicz, Pierre Janet, Gibert, F. Myers, A. Myers, Gurney, Birchall, Guthrie, Van Eeden, Glaron and Podmore.” (p.400)

Although he did not regard the evidence as conclusive, Dr Moll’s book demonstrates that serious scientific investigation of telepathy by the medical profession was being done over a hundred years ago. Since then, while continued research has occurred in respected ‘Western’ scientific establishments (such as Duke university in the USA) as well as Eastern ones (especially in Russia), interpretations of subjective experiences assuming the existence of telepathy have come to be regarded as ‘symptoms’ of serious mental illness and characteristic of schizophrenia. It is, of course, possible to develop delusions 259

about telepathy, this being especially likely if one hears voices when no one is around. This, too is considered characteristic of schizophrenia and listed among Schneider’s list of “first rank symptoms”. In fact the first 3 symptoms involve “auditory hallucinations”, including “hearing voices commenting on ones actions”, “voices arguing” and “hearing ones thought spoken aloud”. Regardless of the source of such voices it is clear that that firstly, the voices are experienced as real by the hearer and secondly, they are attributed to different sources by the hearer, depending on their belief system.

The attribution of voices (by the hearer) may be “scientific” or “religo-spiritual”, or a mixture of these. “Scientific” explanations include telepathic, technological and neurological ones. “Religo-spiritual” explanations include “hearing the voice of God/angels”, “possession”, “channelling”. Since the 1970s, and especially in the past 10 years there have also been claims of ‘channelling’ from extra-terrestrials and ‘meta-terrestrials’, the latter being supposed ‘spiritual beings’ either of now dead people, from ‘other dimensions’ or so-called ‘ascended masters’. Extraordinarily, while New Age magazines exhort the youth to “listen to their inner voice”, reject the skepticism of science and believe in magic, numerology, astrology and other ‘occult arts’, tune into “spiritual guides” and discover their inner wisdom, such beliefs and activities, and the thought processes involved in such belief-systems are regarded as evidence of incurable madness by the medical profession. Not only are people with such beliefs viewed as insane with a ‘biological brain disease’, but their ‘illness’ is said to be largely genetically determined and caused by structural brain damage and/or chemical imbalances rather than being acquired through learning and experiences.

According to medical, psychiatric and psychology texts, and by dictionary definitions, hearing a voice or voices when no one is visibly present is termed an “auditory hallucination” and the source of such voices is assumed to be the very brain and mind of the person who hears them. There is much support for this view in the vast majority of cases, in which instance belief that the voice comes from some external source is incorrect, and therefore delusional. The fact that particular chemical stimulants, especially amphetamines and LSD (less so) can trigger auditory hallucinations while intoxicated adds support to the view that voices in the head can be caused by disturbances in brain chemistry. It is also 260

common experience to hear voices ‘out loud’ occasionally during hypnogogic and hypnopompic states (while waking up and falling asleep), in which case they are not considered “abnormal hallucinations” but are nevertheless still regarded as hallucinations rather than the result of external forces.

All “neurological” explanations for auditory hallucinations are not chemical, and, anyway, a chemical explanation is seriously limited without an anatomical and neurological localisation and integration. In “temporal lobe epilepsy” the explanation of voices in the head is attributed to electrical malfunction: involuntary and stereotyped electrical discharges in the lateral (temporal) lobes of the brain. These are generally treated with “anti-convulsant drugs” and occasionally by brain surgery. While it might seem rather unlikely that the voices characterised as “hallucinations” are the result of telepathic events, the attribution of disembodied voices to “telepathic sources” or more bizarrely “ascended masters” or “extra-terrestrials” is neither unexplainable nor entirely illogical when one considers the literature, television and movies that have shaped the minds and beliefs of young people today. While their logic may be flawed, and based on incorrect assumptions, the reasoning behind the conclusion (or suspicion) as to where the voice or voices originate can be understood. It is of note that, even in 1979, according to the American psychology textbook Psychology and Life, “much of the public” (in the USA) believed in ESP (p.357).

Over the past 140 years, rivalry has occurred between “telepathic” and “spirit” theories to explain a range of phenomena which are regarded as evidence of psychosis by the medical profession or viewed with disbelief regarding their occurrence. Phenomena studied with intent to understand them scientifically include examples of people dreaming or ‘automatically writing’ about events that have affected people far away at the time of the event. Serious injury, near-death and death have been reported by family members of those injured, sometimes very accurately and in surprising detail, at others as a more vague concern or sensation. There have also been many well-authenticated reports of people having premonitions of future events. These have also been looked at by “parapsychologists”, who have also attempted to scientifically refute or validate reports of people transmitting messages from people now dead. 261

The serious study of such phenomena was regarded as a legitimate subject, indeed an important one, for scientists to research and hypothesise about one hundred years ago, and many of those who became convinced of the existence of telepathy came to do so from positions of skepticism and disbelief. During the 20th century a clear divide developed between ‘psychology’ and ‘parapsychology’, with ‘mainstream psychology’ becoming closely aligned, theoretically, with medical psychiatry, and developing a sense of ‘scientific’ (and intellectual) superiority over “parapsychologists”. Psychiatrists and medical doctors, generally, regarded the study of ‘parapsychology’ as unscientific, “pseudo- scientific” or frankly delusional. Another reason why ‘parapsychology’ became discredited was the unscientific way in which proof of various theories was claimed and the design of various experiments. Also the topics studied by ‘parapsychologists’ evoked superstitious fear among the public at times, fed by hostility from the Christian Churches to anything that seemed like “occultism”, polytheism or “animism”. The politics and history of this confrontation between scientific and religious ideas about the mind and ‘transference of thought’ are complex, but must be understood if we are to understand the many “symptoms” Karl Schneider listed as “first rank symptoms of schizophrenia”.

If telepathy does occur massive changes are required to the medical and psychiatric paradigm, and huge changes will be necessary to public health strategies and research conclusions which equate “familial clustering” of various diseases with “genetic factors”. In fact, even without the existence of telepathy, what is now known about psychophysiology and psychology necessitate such changes. Consider current prevention strategies for breast cancer and the research conclusion that schizophrenia is (partly) inherited because identical twins taken from ‘schizophrenic’ mothers and raised separately are more likely to both be diagnosed with schizophrenia than non-identical twins and other siblings. Both, if reassessed taking possible telepathic influences into consideration, result in very different conclusions.

The incidence of diagnosis of breast cancer and the incidence of the disease has increased in recent years. This partly reflects an “aging population” (since incidence of breast cancer increases with age), but other factors, including psychological, hormonal, chemical (such a cigarette smoking) and radiation 262

factors may also be involved in the noted increase in this and other cancers. The main risk factor promoted by the medical profession and breast-cancer prevention strategies is a hypothesised genetic tendency, based on which women are advised to have regular mammograms. In some cases women have even had their breasts amputated to avoid a predicted risk of developing the cancer because several close family members have developed the disease or they have been found to have a breast cancer ‘oncogene’. It has been observed that the daughters of women who have developed breast cancer are more likely to develop the disease as are their sisters (first degree relatives). Breast cancer in aunts and cousins is also reported to increase likelihood of developing this cancer (and also bowel cancer and several other cancers).

The paradigm on which research into and treatment of breast cancer and other cancers is based ignores two psycho-physiological possibilities: both of which could lead to spurious evidence in support of “oncogenes” (cancer-causing genes) or other such gene-related theories to explain this family clustering. The first, and most important, is the possibility that fear of cancer, specific or general, could increase likelihood of developing the disease. It is easy to see why women whose mothers or siblings developed breast cancer (or other serious diseases) would worry about developing the disease themselves. A related possibility is that other psychological factors (such as attitudes) which are similarly “clustered” (shared) among family members and can be inherited, not because of shared genes, but because of shared experiences and children accepting the opinions and ideas of the parents. Children develop similar attitudes (such as optimism or pessimism) and beliefs (including scientific, political, social and religious ones) by learning them from their parents and siblings (especially older siblings). This obviously occurs to some degree in everyone, and, although frequently neglected, is acknowledged by scientific researchers in their quest to prove genetic inheritance through studies on identical and non-identical twins who have been raised apart from each other and apart from their biological parents. This is meant to exclude the possibility that schizophrenia is caused by shared experiences in families rather than genes. Conclusions regarding genetic predisposition based on such studies are invalidated in the presence of telepathy. Monozygotic and dizygotic twin and adoption studies have not been considered necessary prior to categorical claims that the development of breast cancer is genetically determined, but they probably are. 263

The standard, “benchmark” research techniques for investigation of genetic factors in different illnesses assume the non-existence of telepathy, including the extensive “twin studies” which have purportedly shown “genetic tendency” in the development of schizophrenia, attention deficit/hyperactivity disorder and manic-depression (“bipolar affective disorder”). These studies are largely retrospective, and compare the diagnosis of mental illness in monozygotic (“identical”) and dizygotic (“non-identical”) twins. Monozygotic twins, who are always of the same gender, have (almost) identical genetic codes in their chromosomes.

Monozygotic twins are not, of course, literally “identical”. They differ in appearance, personality and beliefs, even if the DNA in their cells is identical (this differs slightly between monozygotic twins due to intrauterine and postnatal mutations). The special relationship of twins and the close emotional connection between them, together with their shared genes, might be expected to increase the likelihood of telepathic communication between identical twins compared with non-identical twins or non-twins. Telepathy between twins, which has certainly been reported anecdotally, would obviously challenge conclusions about the “genetic” inheritance of schizophrenia if these are made on the basis of twin studies. Likewise telepathic influence of parents on children and siblings on each other explain the “familial clustering” of schizophrenia at least as well as “genetic theories” or “chemical imbalance theories” do. A significant point is that in addition to discounting the possibility of telepathy in psychiatric and medical research, beliefs in telepathy themselves are diagnosable as “delusional”, according to Schneider’s ‘first rank symptoms’. If to this is added the factors of shared family beliefs, the political and social control elements, the influence of religious and cultural elitism (and antagonism), the reactions of the diagnosed individual (and family) to diagnosis and treatment and the phenomenon of “self-fulfilling prophesies” an integrated aetiological theory of schizophrenia can be developed which explains both the ‘positive’ and ‘negative’ symptoms of the disease. Such a theory is not simple, but then, neither is “schizophrenia”.

264

NASTY LABELS

The Dorland Medical Dictionary defines telepathy as “extrasensory perception of the mental activity of another person”. “Delusion” is defined as “a false belief which cannot be corrected by reason” stating also that “it is logically founded and cannot be corrected by argument or persuasion or even by the evidence of the patient’s own senses” (p.418). The following types of delusions are defined: depressive delusions, expansive delusions, delusions of grandeur, delusions of negation, nihilistic delusions, delusions of persecution, delusions of reference, somatic delusions, systematized delusions and unsystematized delusions. A “depressive delusion” is defined as a “delusion in which the patient experiences feelings of uneasiness, unworthiness and futility”; a “delusion of grandeur” as “delusional conviction of one’s own importance, power, wealth etc”; “expansive delusion” as “a pathologically unreasonable belief in one’s own greatness, goodness or power”. “Delusions of grandeur” are said to be found in “megalomania, dementia paralytica [chronic syphilis infection of the brain] and paranoid schizophrenia”, while expansive delusions of “manic depressive psychosis”. “Delusions of persecution” are also said to be characteristic of paranoid schizophrenia, defined in the Dorland’s Medical Dictionary as “a morbid belief on the part of a patient that he is being mistreated, slandered, and injured by secret enemies”.

The 1998 Encyclopaedia of Mental Health edited by a professor of psychology at the University of California (Howard Friedman), categorises the delusions of schizophrenia as “delusions of control”, “delusions of grandeur” and “delusions of persecution”, describing also “more specific delusions” such as “thought broadcasting” (the belief that one’s thoughts are transmitted so that others know them) and “thought withdrawal” (the belief that an external force has stolen one’s thoughts) (p.400). The last two examples of “delusions” are listed among Schneider’s “first rank symptoms”. While it appears true that genuine delusions can occur regarding “thought broadcasting”, “thought insertion” and “thought withdrawal” it is important to look at these concepts holistically and logically before deciding such beliefs to be indicative of mental illness rather that ordinary confusion which is amenable to correction by discussion and education. It is also possible for “thought disorder” to be diagnosed because of 265

confusion about a person’s use of language. Could not plagiarism (stealing of people’s ideas) be regarded as “thought withdrawal”, and could not the effects of advertising and doctrinal education be viewed as “thought insertion”? If it is true that telepathy exists, or even if it is not, how can belief in “thought broadcasting” per se be regarded as delusional?

The “symptoms” of “thought broadcasting”, “thought insertion” and “thought withdrawal”, “classical signs” of “schizophrenia” may be regarded as “scientific delusions”, if they are indeed delusional. They are based on intellectual interpretation of subjective experiences with the attempted use of internal logic, regardless of how “illogical”, “irrational”, “unusual” or “bizarre” the person’s subsequent beliefs and behaviour might seem to be. Logical extrapolation, even from sound assumptions can result in conclusions that appear “patently absurd” to one who has not followed all the steps of the reasoning process. It can easily be misled or incorporate false assumptions, in which case incorrect (delusional) conclusions will be reached. The construction of a belief system, whether rational or delusional, occurs temporally through the acceptance and rejection of ideas. These ideas may be internally generated (insights) or come from others in the form of words, images etc. Ideas may be received through the eyes and though the ears, and may be accepted or rejected. They may be remembered or forgotten. An idea may be incorporated into the belief system and become a fundamental assumption without conscious awareness of where it originated. Such is the nature of many of our core assumptions, which include scientific, social and moral assumptions. Assumptions of various types underpin belief systems generally, including delusional and non-delusional belief systems. The core assumption may be reasonable but the extrapolations or inferences not so.

The process of developing a belief system involves gathering and integrating bits of information with assumptions one holds to be true. When new ideas are received or thought of oneself they tend to be accepted if they conform to one’s expectations and preconceptions and rejected if they do not. This leads to some degree of “selective listening” and “selective vision” in most people. The fact that one tends to notice what one is expecting also has the effect of tending to strengthen the pre-existing belief. This phenomenon may explain why people’s opinions tend to become more “rigid” as they get older. 266

For many years they have noticed things that strengthen their conviction about things they have assumed, during which time they have also learned more reasons to disbelieve the things they were brought up to disbelieve. However fundamental assumptions do change and may change suddenly. Both the process of such change and the result of such change can be mistaken for “mental illness”, when they may actually be signs of the development of greater mental health and sanity.

Sudden change in behaviour or beliefs can result in concern, worry and even anger among family members (especially, in the case of children, parents). This is especially so with religious and political beliefs. This results from the rejection of previously held beliefs and the expression of different ones. Parents who believe in a particular political, religious, scientific or other dogma may be disturbed, firstly when their child rejects the dogma, and secondly when an alternative theory is expressed which challenges their opinion. These two stages of disturbance may be close to simultaneous, or they may be temporally separated by days, weeks, months, years or even decades. The process may occur in as many areas as dogmas and opposing opinions are held, and may cause varying degrees of disturbance in the parents minds’ with very different outcomes for parent, child and family.

On dismissing the beliefs as “mad” (by any term) the internal logic that underlies most delusions, and the roots of the delusional beliefs remain undiscovered, unchallenged and unchanged. When people are diagnosed as “psychotic” or otherwise mad, the label itself is often regarded as “the cause”: it is assumed that the beliefs cannot be understood, and consequently little or no effort is made to do so. Furthermore, the word “mad” is used to describe anger and rage, and also to describe despotic or evil people as well as opinions regarded as implausible, unreasonable or ridiculous. In the popular media and mass-media and in ‘lay’ society it is common to hear the word “mad” being used alongside “lunatic”, “nutcase”, “mental case” and other terms of abuse. Such terms are not, of course, used in psychiatric and psychological textbooks. However the descriptions of various “mental disorders” in psychiatric textbooks reinforce negative stereotypes while disguising the underlying prejudices with jargon, euphemisms and scientific-sounding words. 267

The term “telepathy” can also be confusing, because the prefix/suffix pathos is also used to mean ‘disease’: hence “pathology”, “pathogenesis”, “nephropathy”, “neuropathy”, “psychopathy” and “sociopathy”. The last two terms, still used in the fields of psychiatry and psychology, have given rise to the stigmatising and commonly used “psychopath” and “sociopath”. These terms have, over the past 100 years, been used interchangeably for people judged by the medical/psychiatric profession to be irredeemably “evil”, many of whom spend most of their life imprisoned (in prisons or asylums). The word “evil” is never used, however, in psychiatric and psychological descriptions of the “conditions”. The 1974 Dorland Medical Dictionary defines “psychopath” as “a person who has an antisocial personality” and “sociopath” as “a person with a psychopathic personality and a pathological attitude toward society”.

Take, for example, the description of “Antisocial Personality Disorder” in the DSM IV. This supposedly incurable “personality disorder” is characterised, according to the widely used reference text, by “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adulthood and continues into adulthood”. The textbook states that:

“Because deceit and manipulation are central features of Antisocial Personality Disorder it may be especially helpful to integrate information acquired from systematic clinical assessment with information collected from collateral sources.” (p.646)

“Systematic clinical assessment” and “information from collateral sources” include asking questions (with the expectation of lying and deceit) and accepting (often without question) reports from other psychiatrists, family members, colleagues and governmental institutions. These sources of “collateral information” are also used routinely to acquire evidence of other “mental abnormalities”, including schizophrenia, delusional disorder and hypomania/mania as well as various “personality disorders”. Not surprisingly, many, or most, people who are given these labels resist them, at least at first. This is 268

termed “lack of insight”, and regarded as a common problem in “psychotic disorders”. By this definition, the acceptance of the label with coercion over time is regarded as the “gaining of insight”: i.e., accepting what they are told by “health care workers”.

The acceptance of a label of “personality disorder” is to admit to being irredeemably flawed as a human being, since no cure is thought possible. Schizophrenia, delusional disorder and manic- depression are also said to be incurable, however ‘remissions’ are said to occur, when the mental state is “normal”. This is routinely attributed to drug treatment with dopamine-blockers, however it is also taught that many who receive a diagnosis of schizophrenia have only a single “psychotic episode”. Thus “schizophrenia” and “manic-depression” are said to be “mental illnesses” while people with “personality disorders” are not considered mentally ill, and hence recovery or “remission” is not thought possible. A key aspect of this distinction relates to treatment by the law. A person who is “acutely mentally ill” who breaks the law is theoretically regarded as innocent (by reason of insanity) while someone with a “personality disorder” is held legally responsible for their crimes. Thus people with so-called personality disorders populate the prisons, while the locked wards of psychiatric institutions incarcerate the “mentally ill” (many of whom do not regard themselves as such, or, if they do, would still rather be at home).

The label “Antisocial Personality Disorder” is only applicable to persons over the age of 18, according to the DSM IV, however children are not spared “permanently defective” labels. Supposed antisocial and anti-authoritarian behaviour in children is psychiatrically labelled as “conduct disorder” or “oppositional defiant disorder”. These are the currently promoted terms for children who were previously regarded as “delinquent” or “feeble-minded”. Those who were previously labelled “attention-seekers” would now be diagnosed as suffering from “attention deficit/hyperactivity disorder”, “oppositional defiant disorder” or “conduct disorder”. It is clear, from the description of these “disorders” in psychiatric textbooks, that what are primarily social judgements are being described as “medical problems”. Furthermore, these social judgements are harsh, stigmatising and grossly unfair. 269

The DSM IV describes “conduct disorder” as “a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated”, characterised by four main “groupings of behaviors”: “aggressive conduct that causes or threatens physical harm to other people or animals”, “non-aggressive conduct that causes property loss or damage”, “deceitfulness or theft” and “serious violation of rules” (p.85). According to the textbook, running away from home, if it occurs twice (or once “if the individual did not return for a lengthy period of time”), is to be regarded as a “symptom” of conduct disorder. Providing two linguistic “loop-holes” it states that “runaway episodes that occur as the direct consequence of physical or sexual abuse do not typically qualify for this criterion” (emphasis added). A serious omission, especially for a psychiatry textbook is psychological abuse. This is much more common that physical abuse and is an obvious reason why children run away from home and from “homes” (institutional ‘care’).

“Oppositional defiant disorder” is described in the DSM IV as “a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least 6 months” characterised by frequent occurrence of at least four of the following behaviours: losing temper, arguing with adults, actively defying or refusing to comply with the requests or rules of adults, deliberately doing things that will annoy other people, blaming others for his or her own mistakes or misbehaviour, being touchy or easily annoyed by others, being angry and resentful, or being spiteful and vindictive (p.91).

If one removes the age-ist assumptions and substitutes “others” for “adults”, one might wonder how many politicians, psychiatrists, physicians, professors, priests and parents risk a diagnosis of “mental disorder” for losing their temper frequently, arguing, blaming others, vindictiveness, negativity or hostility.

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It can be seen that psychiatric labels can and have been used as nasty labels; labels which have been applied variably depending on the political climate of the time. These labels are made primarily on the basis of behaviour, although certain modes of thinking and inference, certain beliefs, and certain attitudes are proscribed depending on the dominant paradigm, its own level of paranoia and the social norms of the society in which these labels are applied. The British psychology professor Peter Chadwick, in Understanding Paranoia (1995) claims that, “whether a person is deluded or not is, in the end, a social judgement” and that “we do not decide this on the basis of …a blood test or a brain scan and it is doubtful that we ever will, or should.” (p.12) It would perhaps be more accurate to say that delusions are usually diagnosed because of social judgements, but the specific reasons for which people are diagnosed as ‘psychiatrically’ deluded reflect the particular beliefs and disbeliefs of the elite profession who have, over the past 100 years, crafted the criteria for diagnosis of ‘schizophrenia’ and other ‘psychotic illnesses’. The political, social and philosophical assumptions of this elite have predictably affected the criteria they developed for the diagnosis and proclamation of madness in others, and we shall soon see that their religious assumptions have also influenced these criteria.

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RELIGIOUS WARS FOR CONVERTS AND MADNESS

The age-old battle between the ‘great religions’ for converts has produced many casualties, and many wars have been fought in the name of religion, with fervent belief in the hearts of all the warriors that ‘God’ was on their side. This war between beliefs and belief systems is complex, has continued for hundreds of years, and has claimed countless lives, countless because most of the deaths are not attributed to religious warfare. Consider all the millions who have been killed because of their religious beliefs or the result of warfare between adherents of different religions (the Crusades and conquest of the Americas, for example). Could it be that deep within the diagnostic criteria, terminology and concepts of European, Australian and North American psychiatry lie prejudices against unconventional or discouraged religious beliefs? After all, the psychiatric doctrines which are now taught in medical schools around the world were developed in nations with Protestant and Catholic Christian traditions, and within a ‘Judao-Christian’ philosophical, political and religious paradigm. It would not be surprising if concepts regarding “normal” and “abnormal” beliefs developed in such nations are biased against Hinduism, Buddhism, Islam and other religions.

Even a cursory review of history reveals that declared or undeclared warfare between different religious adherents has been a noticeable and enduring feature of global conflicts over the past 1000 years. Many terrible atrocities have been committed with the fervent belief (or politically expedient claim) that ‘converting’ (or ruling or killing) ‘non-believers’ was divinely sanctioned by the ‘god’ or ‘gods’ of the aggressors. In Australia (and elsewhere), Indigenous children have been taken away from their ‘heathen parents’ to ‘protect’ them and ‘civilize’ them; and to give them ‘a good Christian education’. Adults have been enslaved and suffered the devastation of their culture in an ostensible effort to ‘civilize them’, a central aspect of which was to proscribe their religious and cultural practices and “convert them” to “Christianity”. Regarding conflict between religious doctrines with relevance to modern psychiatry it is also important to recognise the battles which have raged, for several centuries, between different Christian Churches, sects and “denominations”, which have also been characterised by persecution and mass-murder at times. Of these, the four-hundred-year-old conflict between 272

Catholicism and Protestantism is especially obvious. The conflict (and compromise) between Judaism and Christianity is also of relevance to an understanding of psychiatric definitions of psychosis, since the vast majority of influential psychiatric theorists have been of either Jewish or Christian extraction. Psychiatric theory is, however, essentially atheistic and highly intolerant of esoteric, idiosyncratic or iconoclastic ideas about God.

While it might be supposed that the split between science and religion has insulated scientific medicine from religious and theological differences, in the areas of psychiatry and psychology, beliefs which have been traditionally regarded as ‘religious’ or ‘spiritual’ are routinely subject to judgement as to whether they are “normal” or “abnormal”. This is demonstrated in many psychiatric texts describing various spiritual, religious and “quasi-religious” beliefs as indicative of “grandiosity”, “delusions”, “psychosis”, “mania” and “schizophrenia” (in addition to various scientific, psychological and political beliefs). The World Health Organization’s “Brief Psychiatric Rating Scale” (BPRS) contains a series of specific questions which may be used by health workers to elicit, rate and tabulate “symptoms and signs” of “schizophrenia”, “mania” and other “mental illnesses”. According to the BPRS, “unusual though content” can be revealed by asking the following questions:

“Have you been receiving any special messages from people or from the way things are arranged around you? Have you seen any references to yourself on TV or in the newspapers?

Can anyone read your mind?

Do you have a special relationship with God?

Is anything like electricity, X-rays, or radio waves affecting you?

Are thoughts put into your head that are not your own?

Have you felt that you were under the control of another person or force?” 273

An affirmative answer to any of these questions is, according to the BPRS, indicative of delusions, which can then be rated in severity according to how “preoccupied” the person is with their “delusion” and how strongly held the belief is. Confusingly, the rating system (from 1-7, 2 being “very mild” and 7 being “extremely severe”) does not discriminate between “preoccupation” and “disrupted level of functioning”. It is explicitly stated in the BPRS that extremely severe (rating 7) delusions are to be diagnosed either because of “almost total preoccupation” or “disruption to most areas of functioning by delusional thinking”. Of note, given the plethora of New Age books and magazines claiming such things as fact, specific mention is made in the BPRS of “unusual beliefs in psychic powers, spirits, UFOs or unrealistic beliefs in one’s own abilities” as indicative of unusual (delusional) thought content.

A survey of the titles of the Harper-Collins “Aquarian” series of “New Age” books casts light on what young people can be labelled as ‘schizophrenic’ for: An introduction to graphology; Colour Therapy; Dowsing; How to develop your ESP; Incense and candle burning; Invisibility; Levitation; The power of Ch’i; Meditation: the inner way; Practical visualization; Understanding astral projection; Understanding astrology; Understanding auras; Understanding chakras; Understanding crystals; Understanding dreams; Understanding the I Ching; Understanding numerology; Understanding palmistry; Understanding reincarnation; Understanding runes; Understanding tarot.

Understanding Auras: the reality of the human aura (1987) by Joseph Ostrom carries a much- warranted warning, described as a ‘disclaimer’:

“The material in this book is presented for educational and informational purposes only. It is not intended to replace established medical diagnostic procedures or treatment. The author and publishers are in no way responsible for those individual who choose not to heed this disclaimer.”

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The contents of Understanding Auras, if believed, would undoubtedly result in a bizarre, pseudo- scientific delusional system, one that would satisfy current psychiatric criteria for acute schizophrenia. It claims that ‘auras’ are visible as colours which can be clearly seen by specially gifted people (such as Ostrom himself), and that the appearance of the ‘aura’ can be used to diagnose psychological, physical and spiritual problems. The dogmatic text makes various ‘scientific’ statements, and explains ‘auras’ using a combination of ‘Western’ scientific, ‘Eastern’ scientific, ‘Western occultist’ and spiritist (‘spiritualist’) terms and concepts liberally mixed with Hindu, Buddhist and Christian ideas. The book gives the following answer to the question “What is the aura”:

“An aura is a collection of electro-magnetic energies of varying densities which are exiting from the physical, vital, etheric, mental, emotional and spiritual bodies. These particles of energy are suspended around the human body in an oval-shaped field. This oval field or ‘auric egg’ stands out from the body some 2-3 ft (1 m) (on average) on all sides. It is also found above the head and extends below the feet into the ground.

“Another ‘auric egg’ can be found floating above the lower ‘auric egg’. It can be found anywhere from just at the edge of the lower auric bodies to 50 ft (15 m) above them. This separate auric field is called the higher auric bodies.” (p.15)

Ostrom claims that he sees these ‘auras’ with his eyes, and that he retained this ability from his childhood, unlike most other adults. This is how he sees and interprets what he calls the ‘aura’:

“I always see the auric bodies in cross-section much like the layers of an onion that has been sliced down the middle.

“Each layer tells me something different about the person that I am viewing. The first three inner layers represent health matters and personality. The outer two layers are indicators of what is going on within the mental and emotional life of the person. 275

“The auric bands are translucent and colourful, appearing much like the colours in a rainbow, only more subtle in intensity.

“How bright these colours will seem to me varies with each individual. Some stand out like neon lights and others are so dim that it takes special viewing conditions and a great deal of concentration on my part to see them.” (p.16)

“Electromagnetic energies” are a scientific concept with clear and unequivocal meaning. Visible light, along with radiowaves, microwaves, gamma rays, X-rays and cosmic rays are forms of electromagnetic radiation (EMR) of different wavelength and frequency. The ‘visible spectrum’ is that that part of the total EMR spectrum which is visible to the human eye. Just outside this range are the ultraviolet and infrared frequencies, and it is thought that the ‘visible spectrum’ for various animals (including insects) covers some of these frequencies. Electrical currents also cause, around them, what are termed (in conventional physics) electromagnetic fields (EMFs). These are created by natural and artificial electric currents, the fields caused by the electrical activity in our bodies (in the nervous system and blood circulation) being termed “bio-electric magnetic fields”. These fields are invisible, although it is conceivable that light passing through such fields could be altered by them, causing the appearance of ‘auras’ around living organisms (as recorded by ‘Kirlian photography’, say). Biologically-generated electromagnetic fields can apparently be measured (with machines such as the so-called ‘SQUID’- Superconducting Quantum Interference Device), and they are minute in intensity compared to those generated by artificial electricity (due to the massive difference in the relative strength of electric currents in living organisms compared with man-made electricity or inorganic natural electrical discharges, such as lightening).

While some form of electro-magnetic radiation has been postulated, over the years, as a mechanism behind telepathy, such theories are highly speculative and not well supported by the available evidence. It has also been credibly postulated that, like many other vertebrates, humans have some ability to sense variations in ambient magnetic fields: that we have, located somewhere in our brains, a magnetic sense organ. The best known proponent of this theory, and an acknowledged authority on bio- magnetism, is the American physiologist Robert Becker, who identifies the pineal organ in the centre 276

of the brain as having a ‘magnetic sense’ (Becker, 1990, p.76-77). Such a sense is common in various vertebrate and invertebrate species, and is thought to be related to an animal’s sense of direction. In birds the pineal’s role in magneto-sensation is relatively uncontroversial. In humans, although a magneto-sensory function for the pineal is subject to some doubt, its overall importance is not, in view of the fact that it secretes several important hormones, notably the indole amines melatonin and serotonin.

The pineal organ, a small pine-cone shaped structure in the brain of humans and almost all other vertebrates has long been the centre of scientific controversy as well as being located at the geometric centre of the brain. This controversy is deeply connected with religious conflict, because, for thousands of years, in India, and later elsewhere in the East, the pineal has been regarded as being the important “Third Eye” which was regarded as having the “spiritual” function of perceiving truth. The controversy arises because the search for truth, while it may be considered a “spiritual quest”, is also a scientific, philosophical and theological quest. Science, philosophy, theology and ritualised religion have, as will be seen, often been at odds with each other. There have also been compromises between major schools of thought in the relevant disciplines, especially when they have had to co-exist in the same nations, states, cities or institutions. In the case of the pineal organ and the myth about a “third eye”, both institutional religion and institutional science, as well as the politics of deception had reason to discourage the idea that humans have the inherent ability to perceive truth for themselves and that the development of this ability is essential for spiritual and physical health. It was easy to disbelieve, anyway; but not so the later discoveries about the importance of the pineal.

Throughout the 20th century, medical schools in Australia taught that the pineal was of minimal importance (initially, in fact, that it had no use of all –that it was vestigial), in line with universities in England and the USA. Training doctors were also taught to disbelieve theories about magnetic fields, such as those of Robert Becker, if these were mentioned at all. During the ‘Cold War’, students in Australia and elsewhere in the ‘Commonwealth’ to regard ‘Communist Science’ (Russian and Chinese science) with much more scepticism than was suggested for science emanating from British and 277

American Universities. It was mainly in Russia that work on neural biomagnetic fields was conducted in the 1960s and 1970s, Becker’s work being a notable exception. In Crosscurrents (1990), Dr Becker writes:

“Our use of energy for power and communications has radically changed the total electromagnetic field of the Earth. Because we cannot directly perceive this with any of our senses, most of us are unaware that it has occurred. Before 1900, the Earth’s electromagnetic field was composed simply of the field and its associated micropulsations, visible light, and random discharges of lightening. Today we swim in a sea of energy that is almost totally man- made.” (p.187)

Through many years of research, Robert Becker has reached the conclusion that, “the exposure of living organisms to abnormal electromagnetic fields results in significant abnormalities in physiology and function”. In Crosscurrents he ties the evidence together, giving several examples of artificial EMR and EMFs causing health problems, and also of many studies being sponsored by the electricity industry and US military to discredit this evidence and present contradictory findings. These health problems include blindness (via cataracts), cancers (especially brain tumours and white blood cell cancers such as leukaemia and lymphoma) and genetic defects. Obviously, Robert Becker believes that invisible radiation can affect humans (and he is correct in this belief). However, the W.H.O.’s Brief Psychiatric Rating Scale claims that belief that “anything like electricity, X-Rays, or radio waves affecting you” is indicative of (psychotic) delusions. Dr Becker reveals how much and whose vested interests lie in denial of EMR-induced damage:

“The growth of electric power and communication systems was slow at first, but since World War II it has been increasing at between 5 and 10 percent per year. In addition, new technologies have appeared. Commercial telephone and television satellite transmitters and relays blanket the Earth from 25,000 miles out in space. Military satellites cruise by every point on Earth once an hour, and from their altitude of only 250 miles, they bounce radar beams off its surface to produce images for later ‘downloading’ over their home countries. New TV and 278

FM stations come on the air weekly. The industry has placed in the hands of the public such gadgets as citizens-band radios and cellular telephones.

“Engineers propose gigantic solar-power stations in space, which would relay the electrical energy to Earth by means of enormously powerful microwave beams. Electrical-power transmission lines are operating at millions of volts and thousands of amperes of current. Military services of every country use all parts of the electromagnetic spectrum for communications and surveillance, and the use of electromagnetic energy as an antipersonnel weapon is being studied.” (p.188)

Being influenced by changes in background electromagnetic fields, or by changes in one’s own bio- magnetic properties is very different from seeing magnetic fields (and different again from ‘seeing’ electromagnetic radiation outside the range defined as the ‘visual spectrum’). Even if magnetic fields can be perceived by people with extraordinary vision, it is difficult to see how precise diagnoses (or even imprecise diagnoses) can be made from their appearance, and they have nothing to do with “etheric”, “vital” or “spiritual” bodies, and. In fact, if one looks at what Understanding Auras claims these ‘bodies’ to be, it becomes clear that these concepts are taken from ‘Western’ occultism, spiritism and mysticism rather than being based on scientific evidence. Adding to the confusion, the book, which claims to present ‘advice on how to see the auras’ explains their interpretation (and existence) using the Vedic concept of chakras. The Sanskrit word chakra, meaning ‘wheel’, has been seconded by the New Age Movement, but the Vedic concept has been turned on its head:

“Charkas [sic] are short, squat, swirling, mini tornadoes of colour strung in an orderly line along the spine from the top of the head to the tailbone. They are energy whirlpools where incoming energy is processed and distributed, and where outgoing energy is cannoned outward to where it must go.” (p.62)

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The belief that energy enters the body from above and radiates out “through the chakras” and can be seen as colours which can be used to diagnose “mental, emotional, physical and spiritual problems” is not based on scientific evidence or traditional doctrines, Eastern or Western. It also satisfies criteria for the diagnosis of ‘bizarre delusions’, especially if interpretations are made along the lines of those suggested in Understanding Auras:

“Some of these centres I see with my physical eyes, although they are faint and I have to rely in my Inner Eye as well as explanations from guides and my higher mind to get a clear picture of how they are functioning. It is not important to actually see these centres in analyzing an aura. If one sees a disruption or a helping ray near the fifth chakra (throat chakra), for example, one only has to know that the fifth chakra is a centre of communication, and depending on the meaning of the colours of the disruption or ray, can assume that the root of the activity is in the area of communication – that is, communication with others or with one’s Self.” (p.62)

Understanding Auras claims, incorrectly, that, “traditionally, any listing of chakras starts at the root chakra”, which is described as the “first chakra”. This is the opposite of the original Vedic doctrine, which teaches that the people should be guided in their thinking by the ‘crown chakra’ at the top of the head. This is an abstract concept related to morally good behaviour, and not a “short, squat, swirling mini tornado of colour”! The problems which can result from trying to see ‘auras’ and convincing oneself that one can see not just auras, but ‘holes’, ‘disruptions’, ‘rays’ and ‘auric bodies’ are obvious, especially if judgements are made such as this:

“The first chakra is found at the base of the spine between the sacrum and the coccyx, or tailbone.

“When disruptions are seen in the auric layers near this chakra the subjects could be suffering (depending on the degrees of disruption) from deep insecurities or immune system malfunctions (such as AIDS) and related diseases. They may display outward symptoms such as greed, theft or a feeling that the world is pushing them around and they have to fight back. They are frightened and they feel there isn’t enough to go round. Disruptions at this centre will 280

create a compulsive personality who is unable to find rest even when surrounded by positive happenings. The basic animal sexual drives are rooted here as well. When disruptions are noted and symptoms of out of control sexual drives are displayed, it is a good bet that the chakra is open too wide, allowing too much base energy in and out. In the case of extreme impotence or frigidity, the flow of energy is cut off from the body.” (p.63)

It is easy to predict the destructive social effects of this offensive rubbish, but what require deeper consideration are the motives of the author and publisher. Believing the many claims of Understanding Auras could certainly lead to delusions and confusion, but is this the intent of the book? Believing that books are written and published with the deliberate intent of causing madness, although theoretically possible, could itself be diagnosed as ‘delusions of control’, since it suggests at most a deliberate conspiracy between the author and publisher, or at least malign intent by the publisher. What benefit could Harper-Collins gain from driving young people mad and getting them diagnosed with schizophrenia? Is this just an unfortunate and unforeseen consequence of the publisher responding to public demand from the “New Age Movement”? Does Joseph Ostrom believe what he has written? Is he, in fact, a real person or has the book been written under a pseudonym (a not uncommon practice)? Why the ‘disclaimer’?

The possibility of intentional deception (in this or any other matter) can be investigated scientifically using processes of logic, deductive reasoning, assessment of probability etc, and an unprejudiced scientific approach requires the consideration of (deliberate) conspiracies, along with inadvertent mistakes when seeking an explanation for whatever are the observed facts. This is true for any area of science: human error can be inadvertent or it can be intentional. In this case the observable fact is that a book, titled Understanding Auras, published by the major publication house Harper-Collins as part of a “New Age” series of books, contains suggestions which, if followed, could, as effectively as a deliberate hypnotic induction into psychotic beliefs, lead to beliefs and behaviour described in current psychiatric texts and other books published by Harper-Collins, as indicative of serious mental illness (e.g., Understanding Paranoia by Peter Chadwick, Harper-Collins, 1995). These suggestions 281

are that with practice, people can train themselves to use their ‘Inner Eye’ to see colours around and above people (and both animate and inanimate objects) and make predictions about the future or to identify health or personality problems in the people they observe. The judgements the book suggests be made, based on a misconstrued Vedic concept (chakras), include medical diagnoses and character/personality judgements of a socially and psychologically destructive nature.

A person who starts looking 15 metres above people he or she meets in an effort to see ‘higher auric bodies’ will obviously be demonstrating a noticeable behavioural peculiarity. If he or she starts seeing colours around (or above) people that no one else sees these would be deemed hallucinations. If assertions are made on the basis of beliefs obtained from Understanding Auras that the ‘observed’ people are suffering from serious medical illness (such as cancer or AIDS) or personality defects (such as greed) on the basis of these colours, with or without a misinterpretation of chakras, significant social effects could be predicted. The people thus diagnosed would likely regard the person seeing the ‘auras’ as mad, and the person making the diagnosis would withdraw from the ‘defective’ or ‘infected’ people. One can easily imagine the social effects of staring at the groins of strangers, or family members for that matter, in an effort to see the colours of their “second chakra” (in the model of Ostrom):

“On the front of the body, just above the genitals and below the navel, is the second chakra. Its location is often reported to be at the genitals, but I perceive it differently. The area of the spine through which it passes is the lower section of the lumbar vertebrae.

“When disruptions are noted near this centre the afflictions are usually of an emotional nature. It is at this chakra that we first process or interpret the emotional world around us. When this centre is seriously afflicted the lower digestive system is affected. The chemical balances in the intestines, colon and stomach are destroyed, ulcers and even various cancers can result. On a temporary, less serious side, we may suffer butterflies in the stomach (something I personally have to deal with before each of my lectures and workshops). (p.64)

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No biographical details are given in Understanding Auras for the author ‘Joseph Ostrom’ (other than those he presents himself) although opposite the disclaimer in the front of the book is a dedication to his wife and daughter, “who gave up her daddy for several precious months”, and to one “Gary Raham”, who receives thanks for “his insight into things scientific”. Gary Raham is described as a ‘delightful sceptic’: the inference being that the book has been subject to scientific scrutiny by a sceptic. The book, which liberally mixes snippets of science with personal anecdotes and occult mysticism, begins with a fairy-tale like “foreword”:

“A large oak, its leaves rattling in the warm summer breeze, lays its cool shadow on a young boy. His feet dangle lazily over the sandy bank at the edge of a small pond. The boy’s eyes watch colourful rainbows dance off the top of a nearby rock. A squirrel, surrounded in a cocoon of blue and green light, peels away an acorn near the rock. The boy extends his hand offering more acorns and the squirrel darts quickly to the far side of the old oak. Jets of light pour out of the boy’s fingertips. Over two decades would pass before he would discover that not everybody saw things as he did.

“That boy was me. He was some of you as well.” (p.9)

This passage is crafted like a hypnotic induction: the warm summer breeze and cool shadow of the oak create a sensation of relaxation, and the imagery of the sandy bank, pond, rock and squirrel, though trite, is vivid. The reader is encouraged to identify with Ostrom as a boy who saw things ‘that not everybody did’. He then claims authority by referring to his “lectures”, and presents ‘evidence’ to suggest that this ‘special ability’ is common:

“In my lectures I usually start by asking for a show of hands from those in the audience who see, or think they have seen, an aura. Now granted, a lecture on the aura will draw a very specific audience, but these people come from all walks of life, all disciplines, almost every stratum of society. When I began asking this question a few years back, the response was that approximately one third of the audience had seen what they thought was an aura at least once in their life. Now I find that the percentage has risen to almost half.” (p.9) 283

In Understanding Auras, Joseph Ostrom refers to his “Inner Eye”. He describes “the spiritual auric body”, which he says he likes to refer to as “the extension cord to God” (which he also describes as “the Source”), as follows:

“Contained within the outer layer (higher mental auric body) is the core of the higher aura. It is called the spiritual auric body. It has been described as an unimaginable, radiant, mother-of- pearl white light. I have seen this auric body with my physical eyes, but my Inner Eye tells me that it is encased in a protective blazing gold shell.” (p.53)

Earlier he equates the “Inner Eye” with a “psychic/intuitive sense”, claiming that he used this “eye” to detect also the “astral auric body”. In describing the “astral auric body” he assumes a belief in reincarnation (past lives):

“The astral auric body is created from the emanations from the astral body which is where we store our complete past and present life history. We draw upon this information as needed in our current lives to further our evolvement as spiritual beings.” (p.35)

The concept of “astral bodies” is derived from Hinduism (Brahmanism), the ancient polytheistic religion of India which was brought to the subcontinent by Aryan Vedic invaders about 3500 years ago, and which subsequently shaped Mahayana ‘Buddhism’ as well as Japanese Shintoism and Tibetan Lamaism.

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Hiroshi Motoyama, a Japanese Shinto priest, in his 1992 book, Karma & Reincarnation begins the first chapter, titled “Individual Karma: Life and Death” with an introduction to “The Three Dimensions”, which claims that:

“The karma and reincarnation of any individual existence functions within the structure of a multi-dimensional reality. As people, or human beings, we exist simultaneously in three dimensions of being: the physical, the astral, and the causal. These are the three dimensions of existence that directly comprise the earth. Over the course of time, our bodies and souls incarnate into and out of these planes through a process we call ‘being born’ and ‘dying’.

“While on earth we possess a corresponding mind, or consciousness, to each of the three bodies. The mind/body complexes overlie and interpenetrate one another. The physical is the smallest of the three and the causal is the largest, extending beyond the physical body in a surrounding oval.” (p.11)

Dr Motoyama then incorporates the Vedic (Indian) concept of chakras into his metaphysical model:

“Each body-mind has within itself seven energy centres for controlling the vital energy and a system of energy channels. These channels are known in Sanskrit as nadis, and the centres controlling them are known as chakras. The chakras also work as centres of interchange between neighbouring dimensions.” (p.11)

He then evokes the Chinese concepts of ‘ying’ and ‘yang’ (without mentioning them) when describing the characteristics of the ‘physical’ and ‘astral’ bodies:

“The astral body/mind is the repository of all desire and all emotion, and unconsciously determines much of our behaviour when we exist within normal human limits. Both the physical and the astral bodies are characterized by duality, the qualities of attraction and 285

repulsion, positive and negative. The physical body sustains itself through the attraction and intake of air, food – all the elements that nourish and sustain it. When functioning in a healthy manner, the body rejects all substances that are harmful or unnecessary to its maintenance, maintaining a balanced relationship to the external environment. When this balance is broken, sickness and abnormality result. Similarly, the astral body attracts what it desires and rejects what it does not desire.” (p.13)

Motoyama presents a complex metaphysical construct including the “physical world”, the “world of spirits” and the “worlds of divine beings”. The ‘world of spirits’ is structured as a hierarchy, with an “upper level of astral world” and a “lower level of astral world”. The astral dimension, according to Motoyama, is “where most people exist after they die”, and the Shinto priest equates these with the Catholic concepts of hell, purgatory and heaven:

“The astral dimension is the other side of life; it is where most people exist after they die. The astral dimension has two divisions, the lower and the higher. The lower astral is similar to the popular notions of hell and purgatory. The higher astral corresponds to the general idea of heaven.” (p.14)

He claims that “as one’s consciousness evolves, one is able to see the astral dimension and to communicate directly with those living in it”. He himself claims such “evolution”, and gives many examples of his own communication with disembodied spirits. In Australia, and by both World Health Organization (ICD-10) and American Psychiatric Association (DSM-IV) criteria such experiences and interpretations are diagnostic of schizophrenia, characterised by ‘bizarre delusions’. They are also typical beliefs of Shintoism and Mahayana Buddhist traditions as well as Hindu traditions (which strongly influenced both Mahayana dogmas and the Shinto religion). Motoyama attempts to integrate these polytheistic religions with Christian concepts in a way that would have been regarded as heretical by the Inquisition, but is an interesting attempt at reconciling and integrating different metaphysical and religious views: 286

“The causal body is the same as the Christian concept of the spirit (as the astral body is to the notion of the soul), in that it is the highest part of our being, the part closest to God. At the moment of creation, the individual is differentiated from the One, and the causal body is born. The causal body is that most closely related to the Absolute; as such, it is beyond duality. Accordingly, it is neither male nor female. All the elements necessary for existence are combined here in perfect equilibrium of pure life energy. The urge to realize this part of our selves and thereby to regain identity with the Absolute engenders the desire for spiritual evolution.” (p.13)

Dr Motoyama’s work might be described as a cosmological and theological theory which draws from many different religious traditions. The result is an inherently superstitious “world view” inconsistent with his description as a “scientist”. He quotes the ancient Hindu Upanishads as providing a “clear explanation of karma, transmigration, and death”. Adding the Chinese concept of ‘meridians’ to the Vedic concept of chakras, Dr Motoyama, who is credited with a PhD in philosophy and psychophysiology, theorises that “people generally leave their bodies” in through different chakras and to different states of being when they die. This depends on their life during ‘this incarnation’ and, in line with doctrines in Hindu Bhagavad Gita, on their thoughts at the moment of death:

“One’s thoughts and ideas at the last moment of life play an important role in deciding where one will go and how one will next incarnate.” (p.92)

He claims that “souls” (he uses the term ‘spirit’ interchangeably) have three possible fates following death: they can become trapped in the “lower astral plane” (‘if they are unable to control their emotions and imagination’), they can inhabit the more pleasant “higher astral plane” (if they are ‘capable of controlling their emotions and imagination’), or they can go directly to the “causal dimension”, which, he says is, “a paradise filled with love and intelligence”, where “the atmosphere is charged with vitality” and the “residents live long and healthy lives”. This fate awaits only those who have devoted their lives to the betterment of the world and attained an “evolved state of love and compassion”, and 287

those who have “attained true wisdom” (and have ‘no earthly attachments’). He comes up with a theory of tormented ghosts, as the fate of those who do not lead virtuous lives:

“The soul and astral body of a person with karma of strong sexual and materialistic attachments moves from the heart to the Svadhisthana Chakra below the navel. The Svadhisthana Chakra controls the unconscious and the urogenital system through the Kidney and Urinary Bladder meridians. These pathways run down the legs and terminate at the tips of the little toe. The soul and astral body travel down the meridian and exit from one of these endpoints.

“The soul stays in the astral body and is born into the lower realms of the astral world where it leads a life of suffering. As we have seen from previous examples, beings in this state are characterized by selfishness. Their attachment is so strong that they tend not to reincarnate for a long time.” (p.91)

According to Dr Motoyama, prayers for those trapped within the lower astral planes can assist in their ascendance to ‘higher astral planes’, thus releasing them from suffering. This can be done at various Shinto Shrines: and he is “head priest of the Tamamitsu Shrine” in Japan, where he founded the “Institute of Religious Psychology” in 1960. At the shrine, Dr Motoyama performs “spiritual consultations”, where he “meditates with him or her, and looks back psychically over their past and present lives to find the root cause of the problem”. The introduction of the book, which provides the preceding information, also claims effectively divine powers for Head Priest Motoyama:

“Through years of spiritual discipline, Dr Motoyama has the ability to unify his being with manifestations of the Absolute that he refers to variously as the higher being, God, expanded consciousness. In this unified state, which transcends the limits of time and space, he is able to directly and clearly perceive the past, the future, and the non-physical dimensions of existence that are connected to the physical realm. In this unified state, his consciousness is able to connect directly with an object in the external world and to affect it. This enables him, for instance, to cure the illness of a person who is in a physically distant location when such action is appropriate.” 288

Karma & Reincarnation does not announce itself as a “New Age book” (as does Understanding Auras) nor does it admit to evangelizing the Shinto religion, or to present the original metaphysical construct of Dr Hiroshi Motoyama; it claims to be a work of science. On the back cover, Motoyama is described as, in order, a “scientist”, “Shinto priest”, “healer”, “guide”, and “parapsychologist”. His work in the research institute he founded in Tokyo, which, it is claimed, has won him international awards and acclaim, is said to be directed towards the scientific understanding of karma, reincarnation and “the evolution of human consciousness”. These are not unreasonable pursuits: it is possible to investigate karma, reincarnation and human evolution (including that of consciousness itself) using scientific modes of thinking. These are inescapably logic-based (if the are to be regarded as ‘scientific’) and directed toward the unbiased (objective) determination of fact (truth). Of course, total (100%) certainty is rarely achieved in science, but, although such assertions are unfashionable, it is possible to determine some facts and laws as absolutely correct. Most accepted facts and laws are, however, only relative truths: they may have exceptions, or they may be partially correct. Particular (scientific) explanations (and theories) may be relatively true in that they are more correct than alternative or competing explanations.

It can be regarded as an absolute truth that human beings (and, say trees) exist. It is also absolutely true that the sun, the moon and the earth exist. It is absolutely true that people think, as was famously pointed out by the French philosopher Rene Descartes in the 17th Century. Descartes was attempting to establish sound foundations for his scientific philosophy, and, by his statement, “I think, therefore I am”, established his existence as a fundamental truth, an incontrovertible “first principle” upon which subsequent beliefs could safely rest. Descartes, who also postulated (but did not claim) that the pineal organ in the brain is the “seat of the soul”, was a scientist and philosopher who has had considerable influence on Western scientific thought, even though his ideas about the pineal and God have been ridiculed in recent years. His ideas and actions had political and religious influence, as well as scientific influence, because he promoted scepticism. He drew the line, however, at scepticism about God. This is hardly surprising given the fate of his scientific predecessors who had challenged the doctrines of the Church, and his own experiences with the Inquisition. 289

Descartes (Latinised as ‘Cartesius’), was born in 1596 in France and died in Sweden in 1650. More is known about his death than his birth. He died, according to historical records, on the 11th of February, 1650, in the palace of Queen Christina of Sweden, in Stockholm, still the capital city of Sweden. It is said that Descartes, who had fled to Sweden to escape the Inquisition in France, died of pneumonia, which he had contracted due the unfamiliar climate and Queen Christina’s insistence that he rise at 5.00 a.m. every morning to teach her philosophy. Looked at from a scientific point of view and considering probabilities, these ‘facts’ about Descartes can be accorded variable degrees of certainty. How close to one hundred percent certainty a particular fact approaches (the date of his birth or death, say) is, hundreds of years later, dependent on the accuracy, or otherwise, of the historical record. And historical records and notorious for presenting biased perspectives and half-truths. Historical records can also contain deliberate untruths: the result of intentional re-writing of history. This occurs for several interconnected reasons centred on power, status and material gain.

The word ‘delusion’ can be used to describe both a delusional belief and the act of deluding someone else. The latter use of the term refers to a person or people misleading or deceiving another or others. It is obvious that people can intentionally delude other people, through propaganda, for instance, and it is equally obvious that delusions (incorrect beliefs) can be transmitted to others without a deliberate intent to deceive. In fact, if false beliefs are strongly and sincerely held they may be more convincing to others.

Frederick Wood, in Training in Thought and Expression (1959) presents a key to the recognition of propaganda repeated from A.J. Mackenzie’s Propaganda Boom (1938). The “Seven Secrets of Propaganda” are, according to this analysis:

1. Repetition: “…he adopts one or two simple points and repeats them continually until the minds of his audience become saturated.” 290

2. Colour: “He must bring personalities into the limelight, surround them with glamour and interest, make the most of any incidents that will serve his purpose.”

3. It should contain at least a kernel of truth: “A deliberate lie is not likely to command credence for long; but when a report, however exaggerated and ‘doctored’, has some truth behind it, the public tends to take the kernel of truth as a proof that all the facts of the story are true.”

4. It should be built around a slogan: “The value of these phrases from a propagandist point of view is that they strike home and provide a rallying-point.”

5. It should be directed towards a specific objective: “Arguments which seem to be directed at our own particular interests should cause us to suspect an ulterior motive.”

6. Concealment of motive: “When a director of a firm of armament manufacturers advocates stronger defence forces he does so from purely disinterested motives.”

7. Timing: “The propagandist must know when to speak and when to remain quiet – in other words, he must be able to gauge ‘the psychological moment’ and to know what will best suit his purpose at a particular time.” (pp. 37-41)

While Frederick Wood focused on examples of German Nazi propaganda, the list above gives some indication of why, in the modern world, it is so difficult to sort out fact from fiction, when we are surrounded and inundated by propaganda from various sources, all intended to influence our beliefs and behaviour, often with the intent of selling something. Although much propaganda is primarily motivated by a desire for financial profit, propaganda has, for thousands of years, been used to increase power and authority over other people: for the purpose of social and political domination. It has also been used, as it obviously was by the German Nazi regime, to motivate the masses for war, and to deceive them into thinking that firstly, they are ‘winning the war’ (or likely to win it); secondly, that their side is morally in the right; and thirdly, that the enemy is fundamentally evil. The last of these, is 291

evidenced in the creation and promotion of various “demonic figures” – usually the political leaders of the enemy nations. During the Second World and for many years after, the most obvious of these “demonic idols” was Adolf Hitler. He remains a “classic example” of an “evil man”, and indeed he was a man who did some horrifically evil things. Was Hitler bad, mad or both? What about the other political leaders of the belligerents in the Second World War: Hirohito of Japan, Mussolini of Italy, Franco of Spain, Stalin of Russia, Churchill of Britain and Roosevelt of the USA?

The American high school textbook As it Happened: A History of the United States (1975) provides this extract from President Roosevelt’s December 1940 address to the American nation:

“The Nazi masters of Germany have made it clear that they intend not only to dominate all life and thought in their own country, but also to enslave the whole of Europe, and then to use the resources of Europe to dominate the rest of the world.

“Three weeks ago their leader stated ‘There are two worlds that stand opposed to each other.’ Then in defiant reply to his opponents, he said this: ‘Others are correct when they say: ‘With this world we cannot ever reconcile ourselves’…I can beat any other power in the world.’ So said the leader of the Nazis.

“In other words, the Axis not merely admits but proclaims that there can be no ultimate peace between their philosophy of government and our philosophy of government…”

Roosevelt went on to call for public support for Great Britain against the “Axis powers”, claiming that:

“If Great Britain goes down, the Axis powers will control the continents of Europe, Asia, Africa, Australia, and the high seas – and they will be in a position to bring enormous military and naval resources against this hemisphere. It is no exaggeration to say that all of us in the 292

Americas would be living at the point of a gun – a gun loaded with explosive bullets, economic as well as military.” (p.694)

As a rule, when politicians say “this is not an exaggeration” it is prudent to be alert to one. In this case the exaggeration is obvious. While many of the claims about the philosophy and agenda of the Nazi’s were true, it is certainly an exaggeration that Americans would literally be enslaved “at the point of a gun” if “Britain went down”. Roosevelt referred, in his address to the nation, to the “Western Hemisphere”, meaning the Americas, which he said had “vast resources and wealth” which constitute the “most tempting loot in all the world”. He predicted that if Germany beat Britain, “we should enter upon a new and terrible era in which the whole world, our hemisphere included, would be run by threats of brute force”, and that “to survive in such a world, we would have to convert ourselves permanently into a militaristic power on the basis of war economy”. ‘War economies’ are fuelled by paranoia and by expansionist (and imperialist) philosophies. Roosevelt chose to ignore the British history of empire building and world domination when he equated Britain’s fight with “Democracy’s fight” and argued that the United States must become “the great arsenal of democracy”:

“Democracy’s fight against world conquest is being greatly aided, and must be more greatly aided, by the rearmament of the United States and by sending every ounce and every ton of munitions and supplies that we can possibly spare to help the defenders who are in the front lines. It is no more unneutral for us to do that than it is for Sweden, Russia and other nations near Germany to send steel and ore and oil and other war materials into Germany every day.

“We are planning our own defense with the utmost urgency; and in its vast scale we must integrate the war needs of Britain and the other free nations in resisting aggression.

“This is not a matter of sentiment or of controversial personal opinion. It is a matter of realistic military policy, based on the advice of our military experts who are in close touch with existing warfare. These military and naval experts and the members of the Congress and the administration have a single-minded purpose – the defence of the United States. 293

“As planes and ships and guns and shells are produced, your Government, with its defense experts, can then determine how best to use them to defend this hemisphere. The decision as to how much shall be sent abroad and how much shall remain at home must be made on the basis of our over-all military necessities.

“We must be the great arsenal of democracy. For us this is an emergency as serious as war itself. We must apply ourselves to our task with the same resolution, the same sense of urgency, the same spirit of patriotism and sacrifice, as we would were we at war.” (As it Happened: A History of the United States p.695)

Having associated the British Empire with “freedom”, “democracy” and the “fight against world conquest”, Roosevelt evoked religious sentiment by claiming that “the British people are conducting an active war against this unholy alliance”. The “unholy alliance” was between the “Axis powers”: Germany, Japan, Italy and Spain. The “Allies” (by inference, the ‘holy alliance’) included Britain, France and the United States. Roosevelt referred to so-called “neutral states”, such as Sweden which supplied raw materials for the German war effort, and suggested that supplying massive amounts of weapons to Britain was equally ‘neutral’. He claimed that by supplying arms to Britain “in sufficient volume and quickly enough”, there was “far less chance of the United States getting into war”.

Roosevelt was not unopposed in his call to arms. Charles Lindbergh, remembered for his pertinent observation that “in times of war truth is always replaced by propaganda”, argued in the New York Times (24.4.41) that:

“We in this country have a right to think of the welfare of America first, just as the people in England thought first of their own country when they encouraged the smaller nations of Europe to fight against hopeless odds. When England asks us to enter this war, she is considering her own future, and that of her empire. In making our reply, I believe we should consider the future of the United States and that of the Western Hemisphere.” (Sellers, 1975, p.696)

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To look at Roosevelt’s arguments from a balanced perspective one must look at the history of the British Empire critically in terms of the crimes against humanity that the “Axis powers”, and German Nazi’s in particular, were accused of. Roosevelt rightly claimed that, “the Nazis have proclaimed…that all other races are their inferiors and therefore subject to their orders”. This was a central assumption of the Nazi eugenics program designed to exterminate ‘inferior races’, which, by their definition, included ‘black races’ (Africans), ‘brown races’ (including Gypsies) and Semitic races (Jews and Arabs). Jews, in particular, were hunted and mercilessly killed by the Nazis, partly because of the many wealthy and influential Jews in Germany (and elsewhere in Europe) at the time, and partly because of long-standing traditions of anti-Semitism in ‘Christian’ Europe. It is important to differentiate anti-Semitism from anti-Judaism, the former being a possibly more malign force than the latter. ‘Anti-Semitism’ refers to racial prejudice and racially-based persecution against people of the Semitic race (Semitic peoples). These include people of both the Moslem and Jewish religions, as well of people with Christian and other religious beliefs. ‘Anti-Judaism’, ‘Anti-Mohammedism”, ‘Anti-Buddhism’, ‘Anti-paganism’, ‘Anti-Hinduism’ and ‘Anti-Christianism’ are references to philosophical positions opposed to the respective religions: they are not racial prejudices but religious ones. While both racial and religious prejudice have fuelled wars in the past (and continue to fuel them in the present) it is not uncommon for the two common prejudices to be confused with each other, so that the actual root causes of various conflicts are obscured.

Religion provides an ideological motivation rather than a mercenary motive for war (though they may be combined, and often are). Ideological motives for warfare are more powerful, and cheaper. Their maintenance demands the ever-increasing use of propaganda. It is ever-increasing because propaganda leads to ‘counter-propaganda’ and this to ‘counter-counter-propaganda’ and so on. The web of lies and excuses for warfare grows like a mental and social cancer. What we now refer to the “First World War” and“Second World War”, when analysed in terms of the underlying ideological conflicts (political, social, religious and racial), can teach us much about the varied use of propaganda, and how it has contributed to the continued misery and wastage of warfare since Roosevelt’s decision to make the United States of America the “great arsenal of democracy”. It can also teach us much about shared delusions and how to see through the delusion that warfare is inevitable and unavoidable. 295

Human beings are not naturally a warlike species. As social creatures we are co-dependent on other human beings for our survival, and as social creatures we savour the company and friendship of others. Children who have been brought up in non-racist, non-sexist, non-ageist environments play together and make friends with others regardless of skin colour, gender, age or religious beliefs. They can, however, develop prejudices against other children in these areas at an early age, reflecting those of the people who influence them. It is adults, and mainly male adults who prepare for war and wage war, although inevitably many who die are children. It is adults who formulate arguments and rationalizations for killing people in the interests of creating peace, and institute totalitarian regimes while claiming to protect democracy and freedom. It is adults who interpret religious scriptures intended to prevent violence to justify acts of violence and then teach this corrupted ideology to children. The Australian educational text Clear Thinking (1961) contains some wisdom from Dr John Rae, who wrote, in an article titled ‘Children and the Myths of War’ (in the Listener):

“Is it not true that even in peace-time, in an age when war is recognized by most to be insanity, children all over the world are still being taught to think of war – that is, the organized killing of human beings by other human beings – as a natural and perhaps noble part of human experience? And if this is so, is it any use adults making elaborate plans to ensure peace when at the same time they are teaching the next generation to accept war?” (p.6)

Dr Rae explains his hope for the future, which many millions share:

“Through our upbringing and education our minds have been conditioned to accept killing. It follows from this that the best way to prevent war would be to educate children to think of killing not just as something abhorrent but also as something of which they themselves are incapable….I would like to see children – everywhere – brought to look upon our present attitude to killing as uncivilized; to be taught that the existing state of affairs need not be permanent, and that man is capable of outgrowing killing as he has outgrown cannibalism. I would want children to be inspired by this vision of a world where deliberate killing is out of date, a barbaric custom practised by the uncivilized tribes of the twentieth century.” (p.7) 296

The Australian high-school history text Australians in Wartime might be examined to see how deeply Dr Rae’s advice had penetrated in twenty years. Published in 1980, the history book presents the following ambiguous conclusion:

“War invariably creates change in a society, for the pressures it creates places great strains on the social and political fabric. Both wars had a profound impact on Australia, arresting some developments and hastening others. War produced significant change in Australia.

“Australians have seen themselves as superb fighters and an honourable people whose word can be relied upon. There is much that is noble and heroic in the story of Australians in wartime, but also much that is regrettable. The tensions of war, it would seem, are both creative and destructive.” (p.89)

The first and second world wars evoked very different responses from the Australian people. Australians in Wartime admits that “Australians greeted the news of outbreak of war on 4 August 1914 with almost indecent enthusiasm”. The Australian Prime Minister, Joseph Cook, declared that “if the old country is at war, so are we”, the ‘old country’ being England, regarded as Australia’s ‘mother country’. The text reveals a shared delusion of the Australian people that resulted in ‘war fever’ and unashamed jingoism:

“Empire loyalty and love of adventure were, it seemed, universal throughout Australia in the early months of the war. From every quarter, from parliaments, shire halls, parish pulpits, metropolitan dailies and obscure rural weeklies, came praise for the nobility of Britain’s response and assurances of Australian loyalty and assistance. Newspaper editors explained that Germany must learn how immoral was the doctrine that ‘might is right’. Germany must learn to respect the rights of smaller, weaker neighbours, as Britain had done in defending Belgium.” (p.7) 297

There was a common belief in Australia that the war would be over in a few days, and that God was on the side of the British Empire. Australians in Wartime quotes the Reverend Samuel Scholes, a Methodist (Christian) priest who exhorted, in the Bendigo Methodist Church:

“It is not for me just now to discuss the various bearings of the situation in which we find ourselves as an Empire involved, but it is not too much to say that in the most deliberate judgement of those most competent to determine, Britain’s attitude is justified not only before the courts of men, but also before the face of Almighty God.”

The text reveals that the Christian clergy in Australia played an active role in disseminating war- propaganda and manipulating the people into enthusiasm for war:

“Australian clergymen gave an indication of how widespread was the enthusiasm for war. Traditionally we might look to the clergy to encourage restraint and to remind people that the Christian virtues of love and tolerance must still apply in war-time. Instead, Australian clergymen eagerly developed the pro-war arguments, abandoning caution and committing themselves wholeheartedly to the war. The battle, they argued, was not about territory, but about principles and they soon demonstrated that since the Empire fought for ideals such as self-sacrifice, integrity and fidelity, its cause must be blessed by God.” (p.8)

The clergy, as quoted in this book, claimed that the war was not “about territory”, which some had suggested it to be. In fact one might say many people recognised it to be about territory, since without doubt territory (including control of territory) was one of the things the protagonists of the First World War were fighting over. Territory is one of the things the protagonists of the Second World War were fighting over as well; the outbreak of this war being greeted with considerably less enthusiasm than that of World War I, during which over 60,000 (mainly young) Australians had been killed in defence 298

of the British Empire. The British Empire had been euphemistically termed the “Commonwealth or Free State” by the British Parliament, back in 1649 (Burne, 1991, p.620). This occurred immediately after the execution of King Charles I by the forces of Oliver Cromwell who had led a civil war against the English aristocracy, again a war for control of territory, but also a war for freedom from oppression. The First and Second World Wars were much more wars for and over territory than ideological or independence wars (which followed, in the 1950s, 60s and 70s). The territory the protagonists were fighting over was the entire world: the land and what lay under the ground, the air and the sea. Furthermore, these same protagonists, with the exceptions of Japan and the USA, had been fighting over this territory from the time they discovered it, four hundred years earlier.

The ‘voyages of discovery’ by Magellan, Vasco da Gama, Bartholomew Dias, Columbus and other Southern European navigators and explorers presented new continents for their aristocracies and those of other European states to conquer and exploit. Previously Europeans had known only of Northern Africa and Asia, both homes to ancient civilizations thousands of years old (and far older than their own). The age of discovery heralded the era of colonisation, as each ‘discovered’ territory was claimed for one European power or another. The Portuguese and Spanish, who led the race at first, claimed the Americas and proceeded to slaughter their inhabitants in the name of God and Christianity, but always with an eye for gold, precious stones and slaves. Those who could be enslaved were not killed: human beings became a valuable “cargo” (somewhat less valued than horses or sheep) and a merciless trade began between European nations for slaves and territories in which people were already enslaved or could easily be enslaved.

In 1494 AD, following Columbus’ discovery of the Americas, Pope Alexander VI issued a ‘papal bull’ (‘holy’ decree) dividing all the new lands which had, or were to be, discovered between the Catholic monarchies of Portugal and Spain. This occurred after negotiations between Ferdinand and Isabella of Spain and John II of Portugal, who managed to have an imaginary line dividing the world into two hemispheres east and west of the Western Atlantic Azores islands, which the Portuguese had claimed, sanctioned by the pope (and thus the Catholic Church). The Spanish were ‘granted’ the Western 299

hemisphere (including the continents of North and South America) and the Portuguese, the Eastern Hemisphere (including Africa and Asia). This followed the ‘discovery’ of the Americas by Columbus, who had been financed by Ferdinand and Isabella of Spain (in 1492), and the successful navigation around the Cape of Good Hope (Southern Africa) by the Portuguese navigator Bartholomew Dias in 1488. Dias had been sponsored by King John II of Portugal, who had ascended the Portuguese throne in 1481 following the death of his father, King Alfonzo V. Two years earlier, in 1479, Spain had become a powerful new force in European politics when Ferdinand of Castile and Isabella of Aragon, who had married 10 years earlier, joined ‘their’ countries in a federation. Ferdinand, Isabella and John were Roman Catholics and with their support the Roman Church (centred in the Vatican) gained religious control of the Iberian Peninsula, which had previously been ruled by Semitic Moslems (Moors) who were allied with the huge Turkish Ottoman Empire. The Ottoman Empire, which was finally destroyed only in the First World War, controlled, in the early 15th Century, territory stretching from modern-day Pakistan and Afghanistan in Asia through Northern Africa to Mali in West Africa and the Southern Iberian peninsula. The Arabian Peninsula, Horn of Africa and Greece were also under Ottoman rule which, as the centre of Moslem political power in the ‘Old World’, became the biggest enemy of the Catholic Church, which was centred in Italy, at first, and later in Germany and Austria.

In the mid-15th Century Italy was divided into several feuding city states – Rome, Naples, Venice, Milan and Florence – all of which bowed to the authority of the Roman Church and any inquisitions ordered by the papacy. Periodic inquisitions which amounted to a constant inquisition of variable severity and cruelty had been authorised by the Roman Church from the time of Augustine in the 5th Century AD, but they reached their worst ferocity and notoriety in the 15th and 16th Centuries.

The political nature of the ‘religious’ inquisitions is obvious when one looks at who was “questioned” and executed and how, when and why they were killed. Church-officiated and/or inspired inquisitions were conducted all over Europe in the 15th Century, and the victims reflected political and philosophical struggles which continue to this day. The Inquisition of the French peasant heroine Joan of Arc and her subsequent burning as a ‘witch’ in 1431 is one obvious example. Joan, a French peasant 300

girl had, since the age of 13, heard ‘voices’, and would, by modern psychiatric criteria, be diagnosable as ‘schizophrenic’. The voices told Joan that it was God’s will that the English be thrown out of France, which they had been occupying since the English King Henry V defeated the French army after invading France in 1415. Henry V subsequently signed a “treaty of perpetual peace” with Philip, duke of Burgundy (France), and married Catherine, daughter of French ‘imbecile king’ Charles V. This brought Henry closer to his ambition of ruling both the French and English kingdoms. It was the Burgundians who sold the captured Joan of Arc, who had inspired the French troops to victory against the English army in Orleans in 1429, to the British (for 10,000 gold crowns). The British organised for Joan to be tried by an inquisition headed by the Burgundian bishop Cauchon who sentenced her to life imprisonment. In 1431 she was accused of having a “relapse” evidenced by her wearing men’s clothes (possibly all she was given), diagnosed as a “witch” and burnt at the stake. In 1440, a former commander of Joan’s troops, Gilles de Laval, was garrotted and burnt with two ‘accomplices’, after confessing to the murder of at least 200 children. He had been accused of heresy, sodomy, apostasy, sacrilege and violation of clerical immunity. After confessing to experimenting with alchemy and black magic, modelling himself on the depraved Roman emperor Caligula, and torturing and sodomising children after entrapping them, Gilles de Laval is said to have asked for his own execution. Given the inquisition’s notorious techniques of torture and putting words in its victims’ mouths, the ‘confession’ of de Laval tells us more about the preoccupations of the inquisitors than of its victims.

The Roman Church formally approved of physical torture as a means of extracting confessions by the Inquisition in 1255. According to new laws, heresy was to be discovered by pairs of Dominican priests (monks) who went from town to town giving public sermons on the evils of heresy. Those who confessed were supposed to be pardoned, but those who did not could be ‘legally’ tortured until they admitted their guilt. The inquisitors were authorised to impose life imprisonment or execution on those who were judged, or to impose lesser penalties – on individuals, or whole communities. Informers, who were often paid for their information (whether true or false), could remain anonymous, and networks of spies developed throughout Europe, carrying rumour and innuendo to Rome.

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With the papacy and the Vatican located in Rome, this ancient city remained politically powerful, but soon its authority was challenged by the ‘high priests’ of other European cities. In 1378 the French cardinals of the papal court in Avignon (in France) defied Italian authority by ‘electing’ Robert of Geneva, cousin of Charles V (king of France) as a rival pope to the Italian Bartolomeo Prignano, who had been elected by the cardinals of the Vatican as Pope Urban VI. In 1409 a third papacy appeared when the Council of Pisa elected Petros Philargos of Crete as Pope Alexander V. He set up his papal court in Pisa. In 1417 the Pisa papacy ended when Alexander’s successor, John XXIII was found guilty of adultery, sodomy, incest and the poisoning of his predecessor (Alexander) by the clerical council of Constance in Germany. The conclave at Constance, with the support of the German King Sigismund and England’s Henry V, appointed the Italian cardinal Oddone Colonna as the “real” pope, declaring the French pope of Avignon a heretic and frightening the Roman pope, Gregory XII to resign. It was Henry’s armies in France that Joan of Arc fought against, and under the English-German-instituted ‘papal’ authority that she was imprisoned, tortured and executed. Henry V, having married Catherine, daughter of the French king Charles V, was poised to become emperor of England and France when Charles died; however, in 1422, at the age of 35, Henry V died instead. His son and heir, Henry VI, was only nine months old, leaving the German King Sigismund the dominant ruler of the “Holy Roman Empire”, the political power base of which was, at this stage, actually in Germany and Austria, rather than in Rome or Italy. In 1433 Sigismund was crowned emperor of the Roman Empire by Pope Eugenius IV. Eugenius hoped for support in his battle with the clerical council of Basle (in Switzerland). Basle was another city vying for clerical dominance within the “Holy Roman Empire”, along with Constance in Germany, Ferrara and Florence in Italy, and Avignon in France. Each of these cities, and many others, conducted inquisitions.

In 1415 the Czech scholar and priest, Jan Hus, who had spoken out against corruption in the Church, was sentenced to death by the ‘Fathers of the Council of Constance’. Hus, who inspired a Christian sect called “Hussites”, was born into a Bohemian peasant family, and his criticism of ‘indulgences’ by the Church (later echoed by Luther) was popular among the poor and oppressed peasants of his homeland. He was a figurehead of the Czech nationalist movement, which threatened the authority of the German monarchy. Hus was granted an opportunity to ‘recant his heresy’ by the German king Sigismund, but refused to do so and was burnt at the stake for his intransigence. 302

Pope Eugenius, who crowned Sigismund as Emperor, was himself deposed in 1439 by the Basle Council, who elected the wealthy Duke of Savoy, Amadeus VIII as Pope Felix V. Eugenius had just been recognised by the (Greek) Eastern Byzantine Church as the head of both the Roman and Greek churches, which had been split for a thousand years. This split had occurred in the 5th Century, when the Roman Empire was split between the Western Empire, centred in Rome, and the Eastern Empire (Byzantine Empire) centred in Constantinople. The political rift between the Eastern and Western ‘Roman’ Empires followed a theological rift regarding the divinity of Christ and the doctrine of the ‘Trinity’, which came to a head in 484 AD with the Roman Pope Felix III excommunicating Acacius, patriarch of Constantinople, and Zeno the Eastern Emperor. Acacius had issued an edict called the Henotikon, which supported the “Monophysites”, who disputed the doctrine proclaimed by the Council of Chalcedon in 451 AD. The Council had declared that Christ was:

“One substance with us as regarded his manhood; like us in all respects apart from sin; as regards his Godhead, begotten of the Father before the ages, but yet as regards his manhood begotten, for us men and for our salvation, of Mary the Virgin, the Godbearer; one and the same Christ, Son, Lord, Only Begotten, recognized in two natures without confusion, without change, without division, without separation.” (Johnson, 1975, p.92)

The churches and priests that refused to accept this doctrine were termed “Monophysites”, and these included the ancient Churches of Syria, Egypt and Ethiopia. By the time the Greek and Roman churches agreed to unite in 1439, Islam had become the dominant religion in Northern Africa, including Egypt, and throughout the Middle East, and the union of the churches under Pope Eugenius was politically motivated by the advancing threat of the Moslem Ottoman Empire. However, in 1453, Constantinople, the prized capital of the Byzantine Empire, was conquered by the army of the Ottoman Turks. They subsequently made it the capital city of their growing empire, which had long been viewed as the political and religious enemy of “Christendom”.

In 1478 Ferdinand and Isabella reintroduced the inquisition to Spain, which been previously under Moslem (Moor) rule (until mid-14th Century). This resulted in intensification of anti-Semitism and persecution of the Jews in Spain. In 1492 the 150,000 Jews in Spain were given four months to leave 303

the country by the Inquisition and a series of punitive laws restricting Jewish activities was passed by the Catholic administration. Earlier, in the 1390s, hundreds of Jews in Spain had been killed for refusing to be baptised and elsewhere in Europe Jews were persecuted, often with mercenary intent. In 1290 England’s King Edward expelled all Jews from England, confiscating their property and calling in the debts that the Jewish ‘usurers’ were owed. ‘Usury’ – the practice of lending money for profit (through ‘interest’) – was a specialty of Jewish financiers and this was proscribed by Edward by the ‘Statute of Jewry’ of 1275, which offered Jews the opportunity of working as merchants, artisans or farmers. Philip ‘the fair’ of France was less tolerant. In 1306 he replenished the royal treasury after arresting local Jews and confiscating their money.

Throughout the hundreds of years that people were persecuted by the Roman Catholic Inquisitions, those who refused to accept the laws and doctrines of the Church were labelled as “heretics”: they were said to hold and espouse false beliefs, and this was regarded as a heinous crime. However there can be little doubt that the inquisitors themselves were deluded (and often far more deluded than their victims): they suffered from delusions of grandeur and systematised religious delusions.

In their broader but simpler definition as false beliefs, delusions exist in as many areas as beliefs do. People may have political, social, religious, scientific, economic or personal delusions. We have also all grown up with a background of propaganda, which has become increasingly technologically and psychologically sophisticated in recent years following the ‘official’ end of the (never officially declared) ‘Cold War’. In the last few years the bombing of civilians has been justified by our political leaders as being in the interests of establishing democracy, human rights, peace and security. While we are expected to believe that “biological and chemical weapons of mass destruction” are imminent threats from “rogue states” (coincidentally all in the ‘Third World’ and most with predominantly Moslem populations), we are not permitted to regard such warnings as “terrorism”. Instead we are taught to fear deranged and fanatical “terrorists” from the “Third World” who, we are told, have no respect for life or method in their madness. We are told that the biggest social problems in Australia are caused by ‘unemployment’, ‘drug addiction’, ‘mental illness’ and ‘the breakdown of family values’ 304

while the growing gap between rich and poor individuals and nations continues to widen, and our political leaders remain silent on local political, social and economic inequities, compensation to colonised nations for hundreds of years of slavery and exploitation, redistribution of land and wealth, the role governments have played in the breakup and breakdown of families (remember the Stolen Generation), or who has developed and pushed the drugs that society is now addicted to. At the time of writing the Age newspaper informs us here in Australia that the Federal Government which refuses to even discuss a belated treaty with the original inhabitants of our country is considering treaty with the United States, not in the interests of peace, but to further develop the nuclear capability of the United States.

We might ask, then, what influence has the prevailing political and economic environment had on which views are regarded as delusional? How have the religious and political assumptions of the past influenced concepts of sanity and insanity? In what ways do religious, political and scientific beliefs contribute to the development of harmful delusions? Are all delusions harmful, or is it true that “ignorance is bliss”?

Delusions are beliefs. They are, by general acceptance and dictionary definitions, false beliefs (or opinions). By psychiatric definition, however, delusions are not necessarily false, epitomised by the “psychiatric truism”: “a delusion is still a delusion, even if it transpires, by coincidence, to be correct”. This seemingly illogical statement refers to the method by which a belief is acquired, the classical example being a man who believes his wife is having an affair, which she is indeed having, however he comes to his conclusion for ‘unusual’ or ‘bizarre’ reasons. A version of this example is given in Foundations of Clinical Psychiatry (1994) in an effort to establish that “delusions may be true”:

“It is not whether the delusion is absolutely false that is relevant, but rather that the belief is adhered to by the patient very firmly despite manifestly insufficient evidence. For instance, a man was convinced that his wife was having an affair, and indeed she was in a secret relationship. However, the husband’s conviction arose from the interpretation he placed on 305

entirely unrelated events such as the numbers printed on the letter he received from the tax office.” (p.74)

He may have been an enthusiast of numerology! The claim that ‘delusions’ may not be false is contradicted by the definition of delusions in the same textbook:

“Delusions are false ideas, usually of great personal significance, held firmly despite all evidence to the contrary, and are inconsistent with the patient’s sociocultural background.” (p.73)

This definition claims that for false ideas to be regarded as delusional they must be inconsistent with a person’s ‘sociocultural background’. In other words, incorrect beliefs which are widely (or traditionally) held in a particular culture or society are not “delusional”, at least from a psychiatric point of view. This is important given the treatment meted out to those who are diagnosed as having “psychosis” in the modern world, especially in multicultural societies such as Australia.

Subtypes of “delusional disorder” in the 1994 DSM IV are: erotomanic, grandiose, jealous, persecutory, somatic, mixed and unspecified (p.297). This classification, which is repeated in the Australian textbook Foundations of Clinical Psychiatry (1994), is significantly different from previous psychiatric classifications of delusions (for example, those listed in the Dorland’s Medical Dictionary, previously quoted). The American Psychological Association’s Encyclopedia of Psychology (2000) defines delusions as “strongly held personal beliefs which are inconsistent with known facts but which the patient continues to believe despite the contradictory evidence” (p.162).

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The American Psychiatry Association’s Diagnostic and Statistical Manual (DSM IV) distinguishes between “bizarre” and “non-bizarre” delusions, the former being regarded as characteristic of ‘schizophrenia’ and the latter, of “delusional disorder”. Both “psychotic illnesses” are regarded as serious and incurable, although both are considered ‘treatable’: this treatment being primarily dopamine-blocking ‘antipsychotic drugs’. Strangely, given that delusions are irrational beliefs, ‘talk therapies’ are considered, according to modern psychiatric dogma, to be ineffective in curing or even treating delusions. In Australia, America, Europe and elsewhere ‘schizophrenia’ and ‘delusional disorder’ are regarded as mental illnesses so serious that people thus diagnosed who refuse drug treatment are routinely imprisoned and treated against their will with injections of dopamine-blockers.

The assumption that delusions are unhealthy is fundamental to psychiatric theory and practice, but has a far longer history, in that religious traditions have also taught about the evils of delusion. Gautama Siddhartha (the Buddha), the Indian philosopher after whose name “Buddhism” is taken is notable for his detailed theories about how delusion (mara) can be conquered, teaching that the three fundamental vices are hatred, greed and delusion. The man later called “the Buddha” (enlightened one) was one of many philosophers whose teachings have been transformed into dogmas such that they may be termed “religions” (despite his own insistence that his teaching be examined critically and rejected if found to be unsound, or not in accordance with personal experience). Religion generally implies dogmatic beliefs, usually held on the basis of “faith” rather than “proof”. As such, it has been said that many fundamental theological and “spiritual” questions cannot be answered or properly studied by science, in that many of the fundamental questions of spiritual inquiry cannot be proved or disproved by scientific means, for example, the creation of the Universe or the existence of a soul or spirit independent of the body. Even if this were true, and it may not be, people’s beliefs and thinking about these things can be studied scientifically. This is true in theory, but difficult in practice – since one’s own thinking and beliefs make the scientific ideal of objectivity a daunting task.

Acceptance of commonly-held religious, philosophical and scientific views is less intellectually demanding than the thoughtful development of one’s own beliefs on the basis of critical thinking and 307

the careful ascertainment of truth versus untruth. Passive acceptance of the most loudly or forcefully promoted view inevitably leads to erroneous beliefs, however, due to the power politics of propaganda. Consider the influential myths of Genesis, the first book of the Christian Bible and Jewish Torah, which dogmatically states that “God” created the Universe and the Earth as well as all of life, including humans. In the three ‘religions of the Book’, Judaism, Christianity and Islam, the first people were “Adam and Eve” and they lived in the “Garden of Eden”. The basic account of the creation of humankind by God which is accepted by all three religions is contained in the first chapter of the Old Testament of the Christian Bible and of the Jewish Torah: Genesis. Genesis tells the tale of temptation of Adam by Eve, of their “original sin” (eating the forbidden fruit of the tree of knowledge of good and evil), their sons Cain and Abel, and the drowning of all of humanity (except Noah and his family) by a massive flood. This flood, states the Bible, was sent by God to punish humans for their wickedness, but Noah, being the only righteous man in the world, was spared, along with his family, the terrible punishment inflicted on the rest of humanity and the animal world (other than those he saved in the ark he built under direct instructions from God).

This account of “early human history” was taken as literal fact for many hundreds of years, by many millions of people in several countries, but never by the majority of the human population and never in all parts of the world. The Judao-Christian tradition (with shared belief in Genesis and the other books of the Old Testament) has been carried, mainly through Christian missionaries, to every country on the planet, but in some countries it has not been popular because it came into conflict with pre-existing beliefs and religious traditions. In some it has not been popular because of the behaviour of Church and clergy and in some it has not been popular because its teachings conflict with scientific evidence. It is the tradition, however, within which the “Western scientific paradigm” developed. Over the past one hundred years, however, the Church’s insistence in the literal accuracy of the Old Testament of the Bible has waned in the light of geological and biological evidence, and with the widespread acceptance of firstly, our common ancestry with other vertebrates, mammals, primates and apes and secondly, the enormous age of the Earth, estimated as several billion years old. Some, however, still cling to the discredited calculations of Bishop James Ussher. Most would accept that these people are deluded in this particular belief. 308

In 1654 the Irish archbishop of Armagh, James Ussher concluded, after adding up the ages of the Old Testament patriarchs, that the Earth was created at 9.00 am, on the 26th of October 4004 BC. This was accepted as a dogma for over two hundred years by both the Catholic and Protestant Churches, however, in the light of incontrovertible evidence of human existence long before this date, few theologians would claim nowadays that that Earth is only 6000 years old. If they did, they might reasonably be considered to be suffering from a delusion: one created by a specific person at a specific time and place (Ussher, in 1654, in Ireland). It became, however, a shared delusion: one shared by millions of people and actively propagated around the world by often well-meaning people with unshakable faith that the stories of Genesis are literally true.

The widely held belief in the literal truth of the Genesis account is mentioned as an example of “a belief [which] may be unsound because it is based upon an idea which is commonly accepted as true, but which is actually erroneous” in a list of causes of “crooked thinking” in the interesting book by the educator Frederick Wood, Training in Thought and Expression (1959):

“At one time it was generally accepted that the earth was flat, but now we know that was not true. Consequently any beliefs dependent upon this were unsound. In the same way many religious beliefs, such as that of the fall of man, original sin, etc., were the outcome of the supposed literal truth of the opening chapters of the book of Genesis. Now we know that these chapters cannot be taken as a literal statement of fact, and this has rendered necessary the revision of the dependent doctrines. We cannot, of course, always know whether the supposed ‘truths’ on which we base a great part of our thinking are actually true or not. So much that was accepted as true a generation ago has since been proved inadequate or erroneous that we are inclined to be sceptical.” (p.65)

Dr Wood, then English Master at the Firth Park Grammar School in Sheffield, England provided a guide to avoiding common pitfalls which can lead to incorrect beliefs and what he terms “crooked thinking” (as opposed to “straight thinking” – thinking straight). His advice can be applied for the 309

correction of delusions and the avoidance of their development. Prior to the discussion of specific pitfalls, he explains:

“It will be realised…that the basis of all sound thinking is sound beliefs. If our beliefs are unsound and illogical, any theory we base upon these beliefs, or any conclusions we draw from them, will also be unsound and illogical…If only we acquired the habit of taking mental stock of ourselves periodically, and asking Why do I believe this or that? or Why do I hold this opinion? or On what grounds do I subscribe to these ideas? we should probably be surprised at the frequency with which we had to admit to ourselves that the grounds were quite inadequate, and that therefore the beliefs in question were, from a rational point of view, not to be justified.” (p.54)

Dr Wood’s list of “invalid grounds on which beliefs are commonly held” is as follows:

1. Mere habit

2. The will to disbelieve

3. Acceptance of current ideas

4. Blind and unquestioning acceptance of what someone else tells us

5. Reliance on memory, which may play us false

6. Self-interest

7. Prejudice 310

8. Antagonism to some person or party who happens to hold the opposed view

9. Because it is based upon an idea which is commonly accepted as true, but which actually is erroneous

10. Misunderstanding of words and terms

11. Use of vague and undefined terms

12. Coloured terms

13. Euphemisms

He says, of “mere habit”:

“Certain ideas become part of our mental furniture. We have acquired them early in life, or they may even be heirlooms, handed on to us by our parents, and we never trouble even to consider them any more than we consider why we wear a collar or a dinner jacket, or why we prefer to sit in a particular chair at home. It is just habit. Thus we have the person who is a traditional conservative, socialist, prohibitionist, atheist, etc. He made up his mind on the subject years ago, and has never changed it nor questioned the validity of his beliefs since, though the circumstances attendant on the original formation of his opinion may have altered completely. For many people their religious beliefs are probably in this class; and where these beliefs are formulated into a creed which is repeated Sunday by Sunday, this only serves to perpetuate the habit. That there may be advantages in the repetition of a creed is not to be denied, but we should not allow it to lead us into a blind and unthinking acceptance of the beliefs it expresses. A mental habit tends to create a “will to believe” which makes for gullibility and credulity.” (p.55) 311

Family traditions in religion and politics are ubiquitous, and vital to understanding a person’s belief system. They are, however, often neglected by doctors taking psychiatric histories, even when making diagnoses of “delusional thinking” and “psychosis”. This is contrary to accepted psychiatric doctrine, which instructs that delusions should only be diagnosed after considering a patient’s social, educational and cultural background. Professor Keks, in Foundations of Clinical Psychiatry, gives a convoluted and confusing interpretation of this doctrine:

“Delusions with religious or subcultural content can prove difficult to assess. Usually consultations with a member of the patient’s social group is necessary. It should also be kept in mind that what appear to be persecutory delusions may be true. It is not whether the delusion is absolutely false that is relevant, but rather that the belief is adhered to by the patient very firmly despite manifestly insufficient or inappropriate evidence.” (p.74)

Of note, he refers to the assessment, not the diagnosis of delusions. Of course, delusions should only be diagnosed after careful assessment, however often the existence of delusions in those labelled with schizophrenia (or delusional disorder) is assumed and the interviewer (in this case the medical student or junior doctor - the targets of this textbook) is expected merely to “elicit the delusion” and rate its severity. If the supposed delusional belief turns out to be correct, the circular argument of Professor Keks encourages the student to look for “delusional thinking” and “insufficient or inappropriate evidence” in the patient’s reasoning. In other words, according to Professor Keks, delusions can be diagnosed if correct beliefs are held ‘for the wrong reasons’.

This kind of teaching is disastrous and can be expected to cause fundamental philosophical confusion in medical students and the doctors they become. If even true beliefs are regarded as being potentially delusional (a fundamental contradiction), a situation results which is similar to the Soviet (Snezhnevskyism) example described by Professor Bloch. Furthermore, most religious beliefs, being held on the basis of faith and family tradition, are, by the measure of Professor Keks, adhered to despite “manifestly insufficient or inappropriate evidence”. 312

In Australia, as in USA and Europe, most people have been brought up as “traditional Christians”, although far fewer are “practising Christians”. Although immigration and religious conversion have resulted in larger numbers of Buddhists, Hindus, Moslems and adherents of other religions, most people in these parts of the world regard themselves as “Christian” if they claim any religious identity. What people mean by “Christian” varies, however, and there are several competing Christian Churches (denominations): Orthodox, Catholic, Anglican, Methodist, Mormon, Presbyterian and so on. All these churches engage in some degree of missionary activity, all have ritual and dogmatic beliefs, and all claim to believe in “God” and “Jesus Christ”. The fundamental concept of “One God” is shared by other monotheistic religions, notably Islam and Judaism. Judaism, Christianity and Islam are historically and ontologically related, and all arose in what is now called the “Middle East”.

The adoption of the Christian religion by the Roman Empire in the 4th century AD resulted in radical changes to “Christianity”, which was then exported throughout the Roman Empire: the Spain, Portugal, Britain and elsewhere in Europe. Spain and Portugal exported Roman Catholicism to South America and Central America, Africa and Asia during the early years of European “discovery” of the rest of the world. The early voyages of discovery, from 1490AD until the early 1500s were by Spanish and Portuguese representatives of the respective monarchies, who claimed the territories they conquered or “discovered” for their respective crowns, thus creating massive empires. This was followed, in the 1600s by a race between other European nations to do the same. The turbulent 1500s, which saw the continued cruelty of the Inquisition, the massacre of native Americans by Spanish and Portuguese soldiers, and the split by “Protestants” (following Martin Luther) from the Catholic Church, also witnessed the persecution of Jews by the “Christian (Catholic) Church”. The Chronicle of the World reports events in Spain in 1581:

“In the last two decades of the fifteenth century the Inquisition did acquire a fiercesome reputation for the cruel persecution of “deviants” in general and Jews in particular. Some thousands of Conversos – Jewish converts to Christianity – were arrested, thrown in jail and sometimes tortured to extract confessions that they were still practising their old faith. They were encouraged to betray their friends and relations. Some thousands were burnt at the stake.” (p.538) 313

Other proscribed behaviours which were punished by the Spanish Inquisitors at the time, according to the Chronicle, included “witchcraft”, “marital misbehaviour”, “blaspheming when drunk”, “homosexuality” and “using love potions to attract the opposite sex”. In 1585, King Henry III of France also proscribed “the pretended reformed religion”: Protestant Christianity.

The “Reformation”, and the beginning of Protestant Christianity, was marked by the famous actions of the 34-year-old scholar and theologian Martin Luther who nailed a written condemnation of certain practices of the Catholic Church on the doors of the Wittenberg church in Germany on the 31st of October, 1517. Luther objected, in particular, to the idea that absolution of sins could be bought from the Church (“indulgences”), arguing that any Christian who is truly repentant is entitled to forgiveness. In 1520 Pope Leo X issued a “papal bull” condemning Luther’s 95 theses as “heretical and scandalous” and the German theologian was “excommunicated” from the Catholic Church. Luther also argued that priests should not stand between men and the bible, and in 1522 began a German translation, the first edition of which was released in 1534. The example set by Luther of challenging authority inspired, the Chronicle says, a series of peasant revolts in Germany in the 1520s:

“The revolt was not a concerted movement so much as a series of local uprisings against oppression by princes, landlords and the church. It was inspired in part by Martin Luther’s teachings and by radical Christian communities like the one set up at Allstedt in 1523 based on common ownership.

“Some peasant leaders did get as far as drawing up a manifesto at Memmingen. It proposed the abolition of serfdom, the reduction of tithes and the right to choose and expel pastors.” (p.474)

The German princes responded by massacring thousands of peasants at Frankenhausen in 1525 and Luther himself denounced the uprising with a four-paged tract, Against the Murdering Thieving Hordes of Peasants. In doing so Luther echoed the concerns of Augustine (in the 5th Century AD Roman 314

Empire) whose, in the words of the historian Paul Johnson, “real fear sprang from his hatred of religious dissent in alliance with social revolution” (Johnson, 1976, p.85).

Chronicle of the World provides a summary of Luther’s teachings which is of value in understanding some of the core differences between the Catholic and Protestant religions. These have relevance to modern psychiatric diagnosis and both the diagnosis and development of delusions:

“Luther himself never considered his ideas to be anti-Catholic. He justified his denial of transubstantiation (the doctrine that, at the moment of consecration by the priest, the bread and wine become the body and blood of Christ) as a return to earlier Christian teaching. Luther accepted the real presence of Christ, but argued that the bread and wine co-existed with the body and blood, just as hot iron holds fire. This divided him not only from the Catholics but from subsequent reformers, most of whom went further and insisted that the bread and wine were merely symbolic or commemorative.

“In other respects, Luther could claim to be developing ideas which had been part of academic discussion throughout the Middle Ages. A central plank of his theology was his belief in justification by faith alone. For him, salvation was not something to be achieved through quality of life, expressed in good works and prayer, but through faith – this was seen not as coming from the individual’s own efforts, but rather as a free gift of divine grace….”

“Justification by faith also had the effect of emphasising the power and divinity, rather than the suffering and humanity, of Christ – something implicit also in the doctrine of predestination, which was most fully developed by John Calvin and his followers. This taught that an individual’s salvation or otherwise, was foreknown to God and not a matter of free will. Since everyone was either saved or damned, belief in predestination did away with the need for purgatory as a half-way house where sinners were cleansed of sin through suffering and made fit for heaven. The great late mediaeval edifice of prayers for the dead, designed to help souls though purgatory, was swept away.” (p.476) 315

The concept of “free will” is very relevant to modern psychiatry, biology and psychology. A theory of human behaviour which limits itself to questions of “nature versus nurture”, or, in the case of psychology, genetic programming versus environmental programming, leaves little room for the existence of free will. This, of course, reduces human beings to mere automatons. If human behaviour is determined by our instincts, our early childhood experiences and our social training, what about decisions and ideas that are truly our own and generated through free will? Are we to believe that this is an illusion, and that our will is never truly free? That we are how we are brought up to be or how we are genetically endowed? Surely these are merely anachronistic forms of reductionist determinism.

“Faith”, as described by Luther (and his followers), means unquestioning belief in doctrines which cannot be proved scientifically or even logically. It is said that “the Lord works in mysterious ways” and thus the will of God cannot be understood (and should not be questioned) by Man. The belief in “predestination”, a preordained fate which is not altered by “free will”, is, unfortunately, fundamentally disempowering and appears to be contrary to the teachings of Christ as recorded in the Gospels (of the New Testament). Jesus of Nazareth taught that any sinner may enter the “kingdom of heaven” through genuine repentance: a word that implies both recognition and regret for one’s sins and, most importantly, change. To enter the “kingdom of heaven” he taught of the importance of humility, kindness, generosity and love. The path to salvation, as described by Christ is poetically presented in the “Beatitudes” (part of the Sermon on the Mount) of the Gospel according to Matthew:

“Blessed are the poor in spirit: for their’s is the kingdom of heaven.

Blessed are they that mourn: for they shall be comforted.

Blessed are the meek: for they shall inherit the earth.

Blessed are they which do hunger and thirst after righteousness: for

they shall be filled. 316

Blessed are the merciful: for they shall obtain mercy.

Blessed are the pure in heart: for they shall see God.

Blessed are the peacemakers: for they shall be called the children of God.

Blessed are they which are persecuted for righteousness’ sake: for

their’s is the kingdom of heaven.” (King James Version, Matt.5: 3-10)

The concept of God suggested by the Beatitudes may be interpreted in many ways. An abstract concept or a secular interpretation of God (as ‘good’, say) retains the essential philosophy that humility, ‘purity of heart’, peace-making, mercy, and the pursuit of righteousness are virtues, which are vital to spiritual health. One wonders, then, at the spiritual health of many institutions that claim to do God’s bidding according to the example of “His Son”. A literal interpretation suggests that peace-makers might rightly consider themselves the “children of God”. Yet today any peacemaker who calls themselves a son or daughter of God is a candidate for psychiatric diagnosis: belief in a special relationship with God (however the concept is interpreted) is regarded as delusional grandiosity (delusions of grandeur). Even if “God” is interpreted as “Nature”, or even as an indefinable concept, the rigid criteria for diagnosis of “grandiosity” leave no room for argument.

The diversity of views held by the public on such matters as ‘God’, ‘angels’, ‘saints’, ‘demons’ and ‘spirits’ make it imperative that modern psychiatry and psychology make necessary corrections to criteria for the diagnosis of delusions (and serious psychotic mental illness) recognising the prejudices of diagnostic criteria that were framed within a Judao-Christian paradigm and which assumed a hierarchy of supernatural “God”, below which was Man, below which was Animals. Such criteria define many other religious beliefs, including Polytheistic, Esoteric and Animist beliefs as indicative of psychosis. 317

The three tiered hierarchy of God, Man and Animals (and Nature), so visible in Judaism, (exoteric) Christianity and Islam is not a feature of many other religions. “Polytheistic religions” such as Hinduism teach of many gods and of the “God” or “gods” within humans as well as other animals. In some religions particular animals are venerated above humans, and in some Nature itself is considered to be God. For a Hindu to consider that they are “part of God” or intrinsically “divine” implies something very different to a Christian, Moslem or Jew who believes that he is (the only) God. Obviously this is taken into consideration by Indian psychiatrists in India (otherwise the majority of the population would be diagnosed with schizophrenia), and, by stipulating that religious delusions only be diagnosed if they are inconsistent with cultural background, the DSM IV and other psychiatric texts do recognise this obvious problem of ‘transcultural psychiatry’. However, in the case of young people who reject their ‘cultural’ (usually familial) religious beliefs and embrace alien ones no such protection exists. Thus the child of Anglican, Catholic or Methodist parents who entertains ideas obtained from other religions, such as the ‘divinity’ of humans, ‘spiritual enlightenment’, ‘reincarnation’ or ‘transmigration of souls’ is at great risk of psychiatric diagnosis with ‘religious delusions’. Likewise the children of Moslem, Jewish, Hindu or Buddhist parents can be diagnosed for departing from their “cultural beliefs” in the area of religious and spiritual beliefs. Of course, this does not happen to most people who reject their parents’ religion. It only occurs if their parents, caregivers or family become worried or somebody else with the power to arrange medical diagnosis becomes concerned. This has been the case, however, with many diagnosed ‘schizophrenics’, and in many situations their diagnosis has occurred at a time of religious, philosophical and ‘spiritual’ confusion or change. Needless to say, incarceration followed by injections and tablets of dopamine-blockers while successfully stopping people from talking about their religious views has a poor record in ‘curing’ them or correcting their confusion.

Ironically, many of the people who are diagnosed as acutely psychotic (with schizophrenia or mania) do not themselves feel confused. On the contrary, they often feel exceptionally lucid and clear, as if they are breaking through mass-deception and things make more sense: they are understanding the world and themselves better, and feeling better, in other words. Such changes of perception, the 318

objective of many religious traditions and philosophical quests, is to be viewed with suspicion according to psychiatric texts: it could be that the person has an ‘elevated mood’. The W.H.O’s ‘Brief Psychiatric Rating Scale’ advises that “moderate elevated mood” (rating 4) is to be judged if a patient shows “excessive or unrealistic feelings of well-being, cheerfulness, confidence or optimism inappropriate to circumstances, some of the time.” People with “moderately severe” (rating 5) ‘elevated mood’ may report, according to the BPRS, “feeling ‘on top of the world’, ‘like everything is falling into place’, or ‘better than ever before’.

Having said this, it is also possible for people to genuinely be both ‘abnormally’ and unhealthily euphoric or ‘high’. Given that a normal level of happiness is difficult to define, arbitrary and variable between localities, ‘abnormal elevation of mood’ is likewise difficult to define. An unhealthy level of euphoria and artificially-induced euphoria are more medically valid concepts. While a mild degree of mood elevation is enjoyable and healthy, extremes of elevation are not. This is especially the case with drug-induced elevation, commonly referred to as ‘intoxication’. The psychological and behavioural effects of psycho-active drugs have been heavily researched over the past fifty years, and the results of this research have been put forward as substantiating the validity of diagnoses such as ‘schizophrenia’ and ‘mania’ as well as the theory that chemical abnormalities (or imbalances) are at the root of these illnesses. In fact, the findings of this research conclusively refute the idea that ‘schizophrenia’ and ‘mania’ are ‘biological diseases caused by structural brain abnormalities’, but conclusively prove that serious mental disturbance can be caused by the ingestion of psycho-active drugs, and that this can be indistinguishable from what is called “schizophrenia” and “mania”. This research also casts light on the complex activities of neurotransmitters in the brain, and the activity of the brain, generally. However much their importance has been exaggerated, neurotransmitters are vital for thinking, healthy or not. This will be explored later when we consider the role of neurotransmitters in the speed and intensity of thought, emotion and movement.

One central belief of many Eastern religions, notably Hinduism and the Mahayana schools of Buddhism is in “reincarnation”. This, in its simplest form, means that the same ‘spirit’ (or ‘soul’) is ‘reborn’ in different “incarnations”. Belief in reincarnation also exists in certain Christian and Jewish sects, but has been actively proscribed by the Catholic and Protestant Churches over the past 500 years. 319

This is clearly reflected in diagnostic criteria for ‘schizophrenia’ and ‘bizarre delusions’. A recent documented example of belief in reincarnation (or allegorical reference to it) together with not uncommon New-Age beliefs and an interesting philosophical and scientific quest being diagnosed as “symptoms” of “schizophrenia” comes from the 1998 Annual Report of the Mental Health Review Board and Psychosurgery Review Board of Victoria. The report presents “Case 7” in an effort to resolve the question, “Religious beliefs or mental illness?”:

“The patient had been diagnosed as suffering from schizophrenia with fixed delusional symptoms. He was preoccupied with his space and research project which involved making further contact with aliens from another planet and believed he and his girlfriend were the living embodiments of people who had been burnt to death as witches in the 17th century. He told the Board he had communicated with aliens from another planet via dreams and astral travel. He did not believe he was mentally ill but was being persecuted for his religious beliefs. He wanted to be discharged from his community treatment order so he could think more clearly and pursue his religious vision.

Held: The Board considered whether the patient’s beliefs could be characterised as religious and, if so, the extent to which they could be taken into account in determining whether he was mentally ill and stated:-

These experiences may be invested by (the patient) with a spiritual or religious aspect but the mere fact that he says or feels that they take place with beings with special powers does not necessarily make them ‘religious’. That is a question of fact, properly to be determined by this Board on the basis of superior court authority…even if (the patient’s) beliefs were ‘religious’, the Board finds that aspects of (the patient’s) ‘religious practice’, namely his interaction with aliens, falls properly into the category of hallucinations, rather than mystical experience with the supernatural…there are aspects to (the patient’s) behaviour and beliefs which support the proposition that he is mentally ill rather than a devotee of a heterodox set of beliefs. His 320

(behaviour and preoccupations) are all indicative of a significant disturbance of thought and mood which has found expression in his preoccupation with (his space research project). Even were his beliefs to be characterised as ‘religious’, the Board can and does take them into account, along with these other factors, to determine (the patient) to be mentally ill.” (p.33)

It appears that the reluctant ‘client’ of the mental health services had more insight into the persecution of heretical beliefs than the psychiatrist and lawyer who refused his freedom to try and contact aliens. Given that millions of dollars of American taxpayers money have been spent in the USA on the Search for Extraterrestrial Intelligence (SETI) program, it is ironic that a young Australian who tries to do his own search for free and with no tools other than his dreams and his brain would be persecuted for his “behaviour”. One must ask what harm his activities, regardless of how deluded, and whether or not they are “characterised as religious”, did to anyone else. His reference to the treatment of ‘witches’ in the 17th century, even if taken literally, is not indicative of madness (merely of belief in reincarnation), but in all likelihood was intended allegorically. It is a popular and well-known example of persecution for unorthodox beliefs, and the man was, after all protesting about being deprived of his liberty and presumably injected against his will for his cherished beliefs. Of course, the young man may have been deluded in an absolute sense of the word: he may have held beliefs about extraterrestrials (“aliens from another planet”) which are factually incorrect based on his dreams and ‘astral travel’, but then, who can be confident about any ideas they have about life on distant planets? Importantly, he should surely be allowed to speculate and believe whatever he likes as long as he is not harming anyone else. Furthermore, dreams and ‘astral travel’ (usually referring to a self-induced trance state) are not, by any reasonable definition, “hallucinations”. In addition, the superstitious prejudice of the Board is shown by their confusion between “contact with aliens” and “mystical experience with the supernatural”. Are we to believe that creatures on or from other planets are “supernatural” – that they are gods?

There is no doubt that people can, nevertheless, be unhealthily (and psychotically) deluded about “God”, believing themselves to be all-powerful, all-knowing or otherwise “supernatural”. They may believe themselves to be The Only God, or the only Messiah. They may believe themselves to be 321

capable of performing miracles when they are not. Successful treatment of such delusions is difficult, but it can be done without recourse to brain-damaging neurotoxins, through the power of logic and rational discussion. A model of how this can be done is presented in the accompanying diagrams and the psychotherapy program I have rather clumsily called “integrated multi-directional learning” for want of a better term. This is a logic and science based process of determining relative and truth which, though challenging the idea of “God as a patriarch in the sky” attempts to accommodate different ideas about God without destructive prejudice. “Integrated multi-directional learning” and ‘holistic psychotherapy’ will be elaborated on in later chapters.

The image of “God” presented in the New Testament, one associated with love and forgiveness (however inconsistent with the behaviour of various Churches), is very different to the vengeful God of the Old Testament. This can be seen in the “Vengeance on the Midianites” by Moses and the Israelites as described in the book of Numbers:

“The LORD said to Moses, “Take vengeance on the Midianites for the Isrealites. After that you will be gathered to your people.” So Moses said to the people, “Arm some of your men to go to war against the Midianites and to carry out the LORD’s vengeance on them. Send into battle a thousand men from each of the tribes of Israel.” So twelve thousand men armed for battle, a thousand from each tribe, were supplied from the clans of Israel. Moses sent them into battle, a thousand from each tribe, along with Phinehas son of Eleazer, the priest, who took with him articles from the sanctuary and the trumpets for signaling.”

“They fought against Midian, as the LORD commanded Moses, and killed every man. Among their victims were Evi, Rekem, Zur, Hur and Reba – the five kings of Midian. They also killed Balaam son of Beor with the sword. The Israelites captured the Midianite women and children and took all the Midianite herds, flocks and goods as plunder. They burned all the towns where the Midianites had settled, as well as all their camps. They took all the plunder and spoils, including the people and animals, and brought the captives, spoils and plunder and Eleazer the priest and the Israelite assembly at their camp on the plains of Moab, by the Jordan across from Jericho. 322

“Moses, Eleazer the priest and all the leaders of the community went to meet them outside the camp. Moses was angry with the officers of the army – the commanders of thousands and the commanders of hundreds – who returned from the battle.

“ ‘Have you allowed all the women to live?’ he asked them. ‘They were the ones who followed Balaam’s advice and were the means of turning the Israelites away from the LORD in what happened at Peor, so that a plague struck the LORD’s people. Now kill all the boys. And kill every woman who has slept with a man, but save for yourselves every girl who has never slept with a man.’ ” (Life Application Bible, New International Version, Numbers 31: 1-18)

The Life Application Bible, published by Zondervan Publishing House and Tyndale Publishing House (USA) presents the following profile of the Midianites:

“The Midianites were a nomadic people who descended from Abraham and his second wife, Keturah. The land of Midian lay far to the south of Canaan, but large bands of Midianites roamed many miles from their homeland, searching for grazing areas for their flocks. Such as group was near the promised land when the Israelites arrived. When Moses fled from Egypt, he took refuge in the land of Midian. His wife and father-in-law were Midianites. Despite this alliance, the Israelites and Midianites were always bitter enemies.”

The notes provide an explanation for the merciless act of Moses which suggests that the mass-murder and plunder of ‘pagans’ is virtuous:

“Because Midianites were responsible for enticing Israel into Baal worship, God commanded Israel to destroy them. But Israel took the women as captives, rather than killing them, probably because of the tempting enticements of the Midianites’ sinful life-style. When we discover sin in our lives, we must deal with it completely. When the Israelites later entered the promised land, it was their indifferent attitude to sin that eventually ruined them. Moses dealt 323

with the sin promptly and completely. When God points out sin, move quickly to remove it from your life.” (p.267)

“Baal”, the “storm god and god of fertility”, was an important god in the ancient polytheistic religion of the Canaanites, which was closely related to that of the Babylonians. It is from Baal that the Christian synonym for Satan, ‘Beelzebub’, is derived (Gray, 1982). According to World Mythology (1993), archeological finds in the 1920s in Northern Syria of ancient Ugaritic texts revealed that in their theology, the adversaries of Baal were Yam (the sea) and Mot (the destructive power of drought and sterility and the god of death). Baal, who controlled the flow of water from the heavens, was credited with bringing the rains on which agriculture depended. The Life Application Bible provides this footnote for “Baal”:

“Baal was the most popular god in Canaan, the land Israel was about to enter. Represented by a bull, symbol of strength and fertility, he was the god of the rains and harvest. The Israelites were continually attracted to Baal worship, in which prostitution played a large part, throughout their years in Canaan. Because Baal was so popular, his name was often used as a generic title for all the local gods.” (p.259)

The massacre of the Midianites, when looked at from a socio-political perspective, presents valuable insights into subsequent justifications for mass-murder in the name of God and the common practice of demonising political opponents for the justification of war, slavery and plunder. The account of the event, as described in the Old Testament book of Numbers, reveals a political alliance between Moses (the political leader) and “Eleazar the priest”, both men. The politico-religious hegemony was instituted as an inherited honour, subject to the control of male elders. This was sanctified, in the scriptures, as being the direct word of God:

“The LORD said to Moses, “Phinehas son of Eleazar, the son of Aaron, the priest, has turned my anger away from the Israelites; for he was as zealous as I am for my honor among them, so 324

that in my zeal I did not put an end to them. Therefore tell him I am making my covenant of peace with him. He and his descendants will have a covenant of lasting priesthood, because he was zealous for the honor of his God and atonement for the Israelites.” (Numbers, 25: 10-13)

The “atonement” that Phinehas had performed was to drive a spear through an Israelite man and Midianite woman who had defied Moses’ ban on Israelite men consorting with Moabite women (who had been blamed for tempting the Israelites to worship “the Baal of Peor”). Several other examples are given in the Old Testament of “God’s vengeance” against people who worshipped many gods (pagans) and other gods (heathens). In Judaism, all of humanity was divided into “Jews” and “gentiles”, a tradition that continued in the Christian Churches as a division between “Christians” and “non- Christians” and parallels the division between “Moslems” and “infidels”. “Non-Christians” include people with widely diverse religious views, ranging from Monotheism to Polytheism to Atheism. In the scriptures of each religious paradigm the beliefs of the ‘non-believers’ are described as being as fundamentally evil. This has led to some of the most monstrous past crimes of (and against) humanity. Surely it requires vigilance and careful scrutiny to root out religious prejudice from politics. The current and historical psychiatric criteria for the diagnosis of schizophrenia suggest that it is also needed in the discipline of psychiatry.

The philosophy expressed in the Beatitudes (Sermon on the Mount) is suggestive of the “law” of cause and effect, popularised in the saying that one reaps what one sows (also based on a Biblical parable). This is similar to the law of “karma” found in Buddhist and Hindu scriptures. The initially Vedic concept of karma, regarded as a fundamental Law of Existence by all schools of Buddhism and Hinduism claims that the present situation is consequent on past actions, and the future on those of the present. Karma is thus a theory of causality, one with moral (‘spiritual’) as well as physical aspects, and is a theory that may be subject to scientific and philosophical scrutiny (and use). The understanding of causality (the relationship between cause and effect) has been a long-standing problem for theologians, philosophers and scientists alike. 325

The law of cause and effect is one which is accepted by both Western and Eastern (and Northern and Southern) paradigms, and can be regarded as a truly Universal Law, at least when applied to physical phenomena. It is difficult, probably impossible, to conceive of a Universe where events do not have causes. Based on the assumption that every event has a cause, one of the main objectives of serious scientific (and philosophical) study is the discovery of these causes. With any search for causes, however, one reaches a point at which an ‘original event’ of (at least presently) unknown causes arises. We may explain the cause of a piece of metal becoming warm when it is left in the sunlight as because of the heating effect of electromagnetic radiation from the sun, but what causes the existence of electromagnetic radiation in the first place, and why does it behave as it does? We may ascertain, through scientific means, that the sun is largely composed of hydrogen and helium, and that these exist as exploding atoms which produce enormous amounts of light that radiates to the Earth and the other planets in the solar system, but where did the sun come from, and why do the atoms of hydrogen and helium behave as they do?

For thousands of years the sun has, understandably in view of its life-sustaining qualities, been an object of great veneration by many cultures. The Roman emperor Constantine, who was baptised as a Christian on his death-bed, was previously a sun-worshipper, this being reflected in the “Christian Church” rituals which began under his patronage. In A History of Christianity (1976) Paul Johnson writes:

“The so-called ‘Edict of Milan’, by which the Roman Empire reversed its policy of hostility to Christianity and accorded it full legal recognition was one of the decisive events in world history. Yet the story behind it is complicated and in some ways mysterious. Christian apologists at the time and later portrayed it as the consequence of Constantine’s own conversion, itself brought about by the miraculous intervention of God before the Battle of the Milvian Bridge outside Rome, where Constantine defeated the usurper Maxentius. This was the story Constantine liked to tell himself, later in life. Bishop Eusebius, who informs us gloatingly that he was ‘honoured with the Emperor’s acquaintance and society’, says he heard from Constantine’s own lips that ‘a most incredible sign appeared to him from heaven.’ But there is a conflict of evidence about the exact time, place and details of this vision, and there is some 326

doubt about the magnitude of Constantine’s change of ideas…He himself appears to have been a sun-worshipper, one of a number of late-pagan cults which had observances in common with the Christians. Thus the followers of Isis adored a madonna nursing her holy child; the cult of Attis and Cybele celebrated a day of blood and fasting, followed by the Hilaria resurrection- feast, a day of joy, on 25 March; the elitist Mithraics, many of whom were senior army officers, ate a sacred meal. Constantine was almost certainly a Mithraist, and his triumphal arch, built after his ‘conversion’, testifies to the Sun-god, or ‘unconquered sun’. Many Christians did not make a clear distinction between this sun-cult and their own. They referred to Christ ‘driving his chariot across the sky’; they held their services on Sunday, knelt towards the East and had their nativity-feast on 25 December, the birthday of the sun at the winter solstice.”

Mithraism involved worship of the originally Persian deity Mithra, ‘preserver of law and order’ and god of the sun and of war. The ancient Persian religion, known from later Zoroastrian writings, included Mithra among a pantheon including “Tishtrya”, the rain-god and “Vayu”, god of air and wind. There was, however, only one “supreme god” in the ancient Persian (and subsequent Zoroastrian) religion, ‘Ahura Mazdah’ (the “Wise Lord”). Ahura Mazdah, symbolising the forces of good, was pitted against ‘Angra Mainyu’, god of darkness and sterility, symbolising the forces of evil (Willis, 1993, p.67). In about 600BC, the Persian prophet Zoroaster (Zarathustra), founder of Zoroastrianism, taught that Ahura Mazdah created the whole beneficient universe while Angra Mainyu, ‘leader of the demon hordes’, created his own evil offspring (vicious animals, whirlwinds, sandstorms and disease) which attack the cosmos and spoil its ideal state. In the Zoroastrian beliefs, the supreme god (Angra Mainyu) is destined to eventually triumph over his evil opponent.

Several analysts have pointed out the similarities between Mithraism, Zoroastrianism and the ‘Christian religion’ founded by Constantine and his immediate successors, and the many differences between the early (before 300 AD) Christian Church (and beliefs) and the Roman religion which developed after 300 AD. Paul Johnson, in A History of Christianity writes, of Constantine: 327

“Many of his ecclesiatical arrangements indicate that he wanted a state Church, with the clergy as civil servants. His own role was not wholly removed from that of the pagan God- emperor…though he preferred the idea of a priest-king. Eusebius says he was present when Constantine entertained a group of bishops and suddenly remarked: ‘You are bishops whose jurisdiction is within the church. But I also am a bishop, ordained by God to oversee those outside the Church.’ Constantine does not seem to have acquired any knowledge of Pauline [St Paul’s] theology but, again according to Eusebius, he apparently imbibed some of Origen’s more grandiose ideas and secularized them, seeing himself as the chief divine instrument. Thus, said Eusebius, he ‘derived the source of imperial authority from above’; he was ‘strong in the power of the sacred title’. Constantine was especially beloved of Christ and ‘by bringing those whom he rules on earth to the only-begotten and saving Word, renders them fit subjects for Christ’s kingdom’; he is ‘interpreter of the word of God’, a powerful voice declaring the laws of truth and godliness to all who dwell on earth’…God, said the Bishop, was the author of kingship, and ‘There is one king, and his Word and royal law is one; a law not subject to the ravages of time, but the living and self-subsisting Word’.” (p.69)

It was during the reign of Constantine that Christianity changed from a persecuted religion to one that was granted imperial favour and sponsorship by the State. Under the rule of the previous Roman Emperors Caligula, Nero and Domitian, Christians, who were the victims of rumours of cannibalism and incest, became official scapegoats for failure or disaster. They were tortured and killed in horrible ways (such as being fed to lions) and were the subject to systematic persecution by the Roman State. Following adoption of Christianity as the official State religion by Constantine, the killing of Christians ceased, temporarily, but by then the characteristics of the Church and the religion had changed radically. Constantine, in 325 AD, inaugurated the Ecumenical Council of Nicaea (in modern-day Turkey), summoning bishops from around the empire to decide on a theological debate which arose from the Alexandrian priest Arius’s argument that “if Christ is the son of God he cannot be eternal since he had a beginning”, and was therefore not “wholly God” (Burne, 1991). The matter was resolved with the adoption of the “Nicene Creed”, which stated that “Christ is ‘of one substance’ with the Father”. This became an official doctrine of the Roman Church (and subsequently of Protestant Christianity also) and before long those who refused to accept this creed were to face persecution. 328

By the time of Constantine’s rule, the Christian Church was already a hierarchical organization with bishops and priests who, as members of the ‘clergy’, were viewed as deserving of obedience from the ‘laity’. Johnson writes of the monumental work of the Alexandrian priest and scholar Origen who, in the 3rd Century AD, created a “Christian theology” which dismissed the (previously venerated) doctrines of the ancient Greek philosophers as false and sanctified a clerical system which later became part of a political-religious hegemony:

“Origen accepted an absolute distinction between clergy and laity. He gave it juridical flavour. He portrayed the Church, as part of his theory of universal knowledge, as a sacred social entity. The analogy was with a political state. Of course the Church had to have its own princes and kings. Of course they governed their congregations far better than corresponding state officials. Their position was infinitely higher and holier, since they administered spiritual things, but their status was similar to those of judges and secular rulers, and therefore the laity had to show them reverence and obedience even if they were inadequate or bad men.” (p.59)

Origen did, however, denounce the avarice and ambition of individual members of the clergy and the clergy as a whole, and had a turbulent relationship with the Church. He was, during his life, attacked for “propagating a false doctrine” and failed to become a bishop, or even be officially ordained as a priest. The account of Origen’s extraordinary behaviour, as told by Johnson, can be retrospectively diagnosed as suggestive of “schizophrenia” (but then, so can the behaviour of Jesus of Nazareth):

“Origen came from Alexandria, the second city of the empire and then its intellectual centre; his father’s martyrdom left him an orphan at seventeen with six younger brothers. He was a hard-working prodigy, at eighteen head of the Catechetical School, and already trained as a literary scholar and teacher. But at this point, probably in 203, he became a religious fanatic and remained one for the next fifty years. He gave up his job and sold his books to concentrate on religion. He slept on the floor, ate no meat, drank no wine, had only one coat and no shoes. He almost certainly castrated himself, in obedience to the notorious text, Matthew 19:12, ‘there are some who have made themselves eunuchs for the kingdom of heaven’s sake.’ Origen’s learning was massive and it was of a highly original kind: he always went back to the sources 329

and thought through the whole process himself…He seems to have worked all day and through most of the night, and was a compulsive writer.” (p.58)

What Johnson describes as Origen’s “fanaticism” would doubtless qualify as “preoccupation” according to modern psychiatry. In fact ‘preoccupation’ can be diagnosed on the basis of far less single-mindedness than Origen displayed. Giving up his job and going around in a single coat and without shoes is definite evidence of ‘self neglect’ and ‘downward social drift’, according to the BPRS and similar ‘symptom’ rating scales. His obsession with what was then a ‘cult religion’ fits comfortably with modern ideas of schizophrenia, and the fact that his father was martyred suggests genetic tendency to one looking for it. His probable act of self-mutilation (castration), based on ‘religious delusions’ would confirm a diagnosis of ‘paranoid schizophrenia’. If modern coercive psychiatry was operational in the 3rd Century AD, he might have returned to his job and realised the ‘inappropriateness of his behaviour’. Likewise, Jesus, given dopamine-blockers rather than crucifixion, might have returned to being a carpenter having been successfully treated for his ‘delusions of grandeur’.

Origen’s younger contemporary, Cyprian of Carthage had a much more politically successful career. Within two years of his conversion he was made a bishop. Born into a wealthy family with a tradition in the Empire’s public service, Cyprian claimed that salvation could only be obtained through the “true Church”, and that the hierarchy of the Church was established by Christ and the apostles. Johnson writes, of Bishop Cyprian’s teaching:

“Through the bishop ‘all ecclesiastical measures whatsoever must be carried out’. Without the office of bishop there could be no Church; and without the Church, no salvation. The man who determined who was, or was not, a member of the Church, and therefore eligible for salvation, was the bishop. He interpreted the scriptures in the light of the Church’s needs in any given situation; the only unambiguous instruction they contained being to remain faithful to the Church and obey its rules. With Cyprian, then, the freedom preached by Paul and based on the power of Christian truth was removed from the ordinary members of the Church; it was 330

retained only by delegated bishops, through whom the Holy Spirit still worked…They were rulers, operating and interpreting a law.” (p.60)

Following the short-lived attempt by Constantine’s successor Julian to restore Paganism as the official religion of the Roman Empire, from the 5th Century AD onwards the ‘Catholic religion’ remained the official state religion of the Empire. The head of the Catholic Church, known as the Pope (Papa, or ‘Father’), was regarded as infallible: God’s representative on Earth. It was Pope Gregory who, in the early 5th Century, sent the Augustine, the bishop of Hippo (in Northern Africa) to evangelise the Anglo- Saxon kingdoms in England. Augustine, regarded as an important Christian saint, regarded physical coercion as a legitimate means to obtaining ‘conversion’. It is from Augustine’s justification of persecution (and motives for persecution) that the Spanish Inquisition, centuries later, drew its inspiration. Johnson defends Augustine, but the bishop’s idea of how heretics should be ‘examined’ says a great deal about the Church’s methods of ‘evangelism’ at the time:

“We must not imagine that Augustine was necessarily a cruel man. Like many later inquisitors, he disliked unnecessary violence and refinements of torture. He thought heretics should be examined ‘not by stretching them on the rack, not by scorching them with flames or furrowing their flesh with iron claws, but by beating them with rods.” (Johnson, 1976, p.116)

The influence of Augustine’s theology on psychology and psychiatry, and on Western thought, generally, is explored in Eternal Day (1998) by the American psychologist Seth Farber. He writes of the bishop:

“When Augustine became powerful and was supported by the Roman state as the Bishop of Carthage, he advocated laws denying civil rights to non-Catholic Christians, evictions from public office, and finally denial of free discussion, exile of ‘heretical’ bishops, and the use of physical coercion. He came to find military force ‘indispensable’ in suppressing his ideological opponents.” (p.62) 331

Dr. Farber quotes Alistair Kee (Constantine vs Christ, 1982) in his analysis of how the Church came to practice the opposite of Christ’s doctrine of non-violence:

“In collaborating with the state the church implicitly or explicitly sanctioned its policies, e.g., war, imperial plunder, slavery, and itself came to emulate these policies as exemplified by the Inquisition. Kee believes that the decision to collaborate with Constantine led to ‘the Great Reversal’. The values of Constantine were deemed to be the values of Christ, were accepted by the Church, and became known as ‘Christianity.’ Kee notes that it is in this way that the values of Constantine – disguised as the values of Christianity – determined the subsequent course of European history.” (p.63)

Seth Farber, in his analysis, presents six “philosophical premises” of “Augustinianism” which resulted from the fusion of Church and State:

1. “…that human beings at present are lacking in intrinsic worth and have lost the capacity to freely choose between good and evil.”

2. “…the situation was not what was originally intended. Human beings were created worthy: they were innocent and good. They were deserving of God’s love. But then a dramatic event occurred – in Augustine’s version, Adam’s sin destroyed the pristine plenitude of being, bringing tragedy in its wake. The paradise that man inhabited was transformed into a Hell; man was transformed from a godlike being into a vile wretch.”

3. “Mankind is now divided into two groups: an elect destined by God to be rescued from its plight and restored to its original condition…, and the masses doomed to eternal torment in Hell.” 332

4. “The transcendence of God is emphasized to the highest degree and stands in marked contrast to the depravity of human beings. This is the core premise of Augustinianism and has had an enduring effect upon Christianity and upon culture: There is an unbridgeable ontological abyss between God and humanity. God is totally Other: Human beings have no right to seek to understand Him or to judge Him by human standards. Whatever He does is right merely because He does it.

5. A preoccupation with sin, guilt and unworthiness.

6. “…an individualistic vision of salvation antithetical to the Christian vision of a new social and cosmic order where the estrangement between human beings, and between human beings and God, is overcome. The Christian vision is eclipsed, and the individual becomes preoccupied with recovering his sense of self-esteem and seeking reassurance that he will be spared the punishment of eternal torment in Hell.” (p.65-66)

Some of these “Augustinian” ideas are clearly derived from the Jewish scriptures subsequently included in the Christian Bible as the “Old Testament”. These include the story of Adam’s temptation by Eve in the Garden of Eden who had been invited to eat of the forbidden fruit (of the tree of knowledge of good and evil) by the Serpent. This “original sin” was punished by God by banishment from the idyllic Garden of Eden and the “fall from grace” (‘Divine Grace’). This story can be interpreted metaphorically or can be accepted literally. It can also be viewed as one of many ‘creation myths’ that made those who developed the myth the centre of creation and the most important part of it. If the ‘Old Testament’ (Jewish) creation myth is to be accepted literally it means that humans did not evolve from other hominids in Africa (or anywhere else): they were created ‘out of dust’ by a miraculous act of God, who only two days earlier had created the sun, moon and stars. According to the account of Genesis, Adam lived to the age of 930 years, and was 130 years old when his third son, Seth was born. Noah, the only ‘righteous man’ on the face of the Earth when God decided to destroy most of the life He had created, was, according to Genesis, a direct descendant of Seth (and thus Adam). The 333

Old Testament also specifies the Israelites as God’s Chosen People: but then, they created this particular concept of God.

The translation of the Bible that is venerated by Christians throughout the “English-speaking world”, and the official Bible of the Anglican Church, is the “King James Version”, translated from the original Hebrew and Greek scriptures in 1611AD. This is commonly held as the Absolute Word of God, and/or “divinely inspired”. It is also regarded as a fascinating and enlightening historical and philosophical text, and this it certainly is. Due to its influence on the legal, political and socio-cultural beliefs in Australia and other nations that were once part of the British Empire, the King James Version of the Bible casts light also on the development of psychiatry. It turns out that (not surprisingly) idiosyncratic beliefs based on different interpretations of the Bible than the officially accepted ones can be diagnosed as “schizophrenia”, as well as iconoclastic views (heresies). To understand how this came to be one must look at the relationship between Church and State in the Roman Empire and subsequently, in the British Empire.

The King James Version of the Bible, the product of 7 years work by scholars from Oxford, Cambridge and Westminister, was commissioned by James I, who is addressed in the “Epistle Dedicatory” as, “The Most High and Mighty Prince, James, by the Grace of God, King of Great Britain, France and Ireland, Defender of the Faith, etc.” The title “Defender of the Faith” had been granted to Henry VIII by Pope Julius II prior to the notorious king’s excommunication by the Catholic Church. Henry VIII’s armies had been part of a “Holy Alliance” between Rome, Spain, Venice and England against France, spearheaded by the warlike Pope Julius. Henry, the second English regent of the house of Tudor came into conflict with the Catholic Church when Pope Clement VII refused to ‘annul’ his marriage to Catherine so that he could marry Anne Boleyn. In 1533AD, assisted by his First Minister, Thomas Cromwell, Henry persuaded the English parliament to make him the head of the Church in England, and give the authority previously vested in the papacy to the Archbishop of Canterbury. He then appointed Anne Boleyn’s friend Thomas Cranmer to the position of Archbishop of Canterbury, who dutifully declared Henry’s marriage to Catherine invalid and blessed his marriage to Anne Boleyn. As 334

it turned out, the ‘blessing’ turned out to be a curse: Boleyn was one of the two wives Henry had executed during his long reign (during which time he married six times).

The treatment of Catherine may explain the behaviour of her daughter Mary Tudor who, during her five-year reign as Queen Mary (England’s first female regent) tried to restore papal authority in England. Mary had hundreds of men and women burnt at the stake for their Protestant faith during this time (Burne, 1991, p.513). This included several bishops. Mary, who was officially illegitimate because of the annulment of her father Henry’s marriage to her mother Catherine, had, of course, much to gain by an assertion of papal authority on the matter of the sanctity of marriage. Mary married her cousin Philip, King of Spain, and together they went to war against England’s continental neighbour, France. Previously, Mary’s father Henry VIII had squandered the wealth of the royal treasury in futile wars against the French, and turned to expropriating the wealth of Catholic monasteries around the country. This was done by his First Minister, Thomas Cromwell, who was eventually executed by Henry as well, along with Sir Thomas More, the author of Utopia, who was killed for refusing to accept Henry’s takeover of the Church.

Elizabeth, the daughter of Anne Boleyn, became Queen Elizabeth I of England when Queen Mary died in 1558. As a woman, she could not be the “supreme head” of the Church, so the English Privy Council gave her the title “Supreme Governor” (of the Church) instead. She made her mother’s chaplain, Matthew Parker, Archbishop of Canterbury.

When Elizabeth I became Queen of England, the European Church was split into four main warring factions: the newly formed Church of England, the Lutherans, the Calvinists and the Roman Catholics. The political power base of the Church of England was London, that of the Catholic Church in Italy and Spain, that of the Lutherans was in Germany and that of the Calvinists in Switzerland and Scotland. In 1559, shortly after her coronation, Elizabeth and the English Church finally repudiated 335

papal authority, and the next year Calvinism (the sect named after the Genevese ‘reformer’ Calvin) was adopted as the official religion of Scotland by the Scottish Parliament. Jean (John) Calvin, who was born in France, was the son of a clerical lawyer, and the theology he developed, drawing on Luther’s work, emphasised the Augustinian doctrine of predestination, giving it a new rigidity and a terrifying visage. Paul Johnson writes, in A History of Christianity:

“…he pounced on Luther’s rediscovery of Augustinian predestination, and drove it to its ultimate conclusion. He began by doubling it: men were not only predestined to be saved, but to be damned. Satan and the devils acted on the command of God: ‘They can neither conceive any evil nor, when they have conceived it, contrive to do it, not having contrived it lift even a little finger to execute it, save in so far as God commands them. God forewills all the tiniest events or actions from all eternity, whether good or evil, according to his plan; some he plans to save, by grace (for all men are evil and worthy of damnation), some he plans to damn. If we ask why God takes pity on some, and why he lets go of the others, there is no answer other than it pleases him to do so.” (p.287)

The Chronicle of the World provides another perspective of Calvin’s frightening theory of salvation or damnation at birth:

“Calvin’s worshippers must adore God; they must also show Him fear. As for sin, Calvin puts forward the doctrine of predestination. God has already chosen the elect: those who will go to heaven. No-one, however devout, can alter the divine decree. What determines whether one is chosen or damned cannot be explained. It is beyond human intelligence, but only the immoral would dare question it.” (p.490)

Calvin did not leave the judging to God. As the religious and political ruler of Geneva, in 1553 he ordered the execution of the Spanish physician Micheal Servetus, who had fled from the Inquisition to Geneva. Servetus, who is credited with discovering cardio-pulmonary (heart-lung) circulation, had 336

criticised the doctrine of the Trinity. With Calvin as ruler of Geneva, Church and State were indistinguishable. His laws demanded strict moral order and social conformity. Respect for God was synonymous with respect for the state and its laws. Dancing was forbidden and pastors appointed doctors to deal with both secular and spiritual education (Burne, 1991, p.507). The moral behaviour of members of society was policed by a hierarchical system of priests headed by Calvin himself.

King James I, who commissioned the King James Version of the Bible, ascended the throne in 1603, when Elizabeth I died. He was the Scottish son of the Catholic martyr Mary, queen of Scots, whom Queen Elizabeth had executed in 1587. Previously James VI of Scotland, James declared himself James I of “Great Britain” and is described in his fulsome “dedicatory” as “King of Great Britain, France and Ireland”. James believed in the “divine right of kings” but also hoped to be a European peacemaker in growing war between the Protestant and Catholic Kingdoms. Consequently, he arranged for his son Charles to marry the 16-year-old Catholic French Princess Henrietta Maria, daughter of Henry IV of France. James also suspended England’s laws against Catholics. Caught in the middle of the war between Protestants (Lutherans and Calvinists) and Catholics, he sought to have his authority supported, as did many others, by religious scriptures. In this case, the scriptures had to be officially “Christian”, but without the “seditious elements” he saw in the competing Geneva translation. It could not support the rebellion of slaves, a growing source of wealth for the British Empire. It could not invalidate his rule or the ‘right’ of his offspring to inherit the throne of England on the basis of blood- lines rather than merit. And it did not.

By all accounts, Jesus of Nazareth challenged the authority of the priestly caste that ruled the Jewish people of his homeland (the Pharisees), but less clearly that of the Roman Empire which dominated the entire Jewish political system: “Give unto Caesar the things that are Caesar’s, but give unto God the things that are God’s”. In the King James Version of the Bible, the Jewish Books of Moses precede the “New Testament” which is a collection of accounts and letters by the early Christian disciples, notably those of St Paul whose mission was to preach the Christian Gospels to the gentiles (non-Jews). Paul, who was himself a Pharisee who persecuted Christians before his conversion, was from the Greek city 337

of Tarsus, and literate in Greek as well as Hebrew, and played a central role in the early development of Christian theology, and its ‘Hellenization’, through which it became palatable to the Roman Empire. Paul Johnson summarises the core precepts of St Paul’s theology as follows:

“Jesus of Nazareth came from the line of David. He was born of a woman, but was established as Son of God, with full power, through his resurrection from the dead. He lived a short life in Palestine, embracing earthly poverty, and for our sins humbled himself in his death on the cross. God raised the crucified and buried one and exalted him to the highest throne at his right hand; ‘For our sake he made him to be sin who knew no sin, so that in him we might become the righteousness of God.’ The atoning death of Jesus the Messiah, sacrificed for our sins, served as our expiation and ransomed humanity. His dying affects the redemption of the cosmos and humanity as a whole, for in his death the world has been crucified and has begun to pass away; Christ will shortly come again from heaven as the Son of Man. Here we have, in all essentials, the central doctrines of Christianity: the view of history, the salvation mechanism, the role and status of Jesus Christ. Everything in it had been implicit in the teachings of Christ. Paul made it explicit, clear and complete. It is a theological system, capable of infinite elaboration, no doubt, but complete in all essentials. It is cosmic and universalist; it is, in fact, Hellenized – Paul, the Jew, whose natural tongue was Aramaic and whose Greek was singular, had supplied the part of the Hellenized processing machine, and thus made Judaic monotheism accessible to the entire Roman world.” (p.37)

In truth, the religion Paul helped create could not be strictly described as “Monotheism” – there were, according to his theology, two gods: Jesus at the right hand of God the father. If he was “at the right hand of God the Father”, he obviously could not be God the Father Himself. This has been a central theological problem in Christianity since the first decades after Jesus’ death. How could Jesus be deified while maintaining the central Jewish tenet that there is only one God. This problem was compounded by the fact that, by all accounts, Jesus himself did not claim to be God himself – only the son of God, a title not necessarily exclusive to himself. Indeed the Jewish religion described all righteous Jews as the sons and daughters of God. Broadening Monotheism to include ‘gentiles’, as was Paul’s mission, might define all good people as sons and daughters of God. This is, in fact, how many 338

people nowadays regard themselves if they maintain a belief in God as a parental figure or being. Many do not consider God to be something that one can be the ‘son’ or ‘daughter’ of. Some believe that ‘God’ is ‘everything’ – including that which we regard as both good and evil. Others believe that God includes only what is good, or that God is “nature”, or “life”, or “truth”.

The King James Version of the Christian Bible, while it may be read from an allegorical and metaphorical perspective, and can be interpreted while keeping in mind the biases of translators and repeaters, makes explicit claims about God and Jesus Christ in the English language which if taken literally are completely inconsistent with known (and not just widely believed) fact. It claims that events have occurred which are, according to commonsense, and scientific evidence, impossible. This impossibility is acknowledged by the term “miracle” – and the Bible tells of many miracles.

Miracles, as the term is used in the Bible, are explanations of causality. The cause is direct ‘intervention’ by God. They are, at best, improbable, at worst, impossible, but it is their very improbability (or impossibility) that makes them miracles. Thus the ‘resurrection of Christ’, a central belief of Pauline theology, is a miraculous event which ‘proves’ both Jesus’ divinity and God’s ability to bring back to life one who was dead. In fact, according to the accounts of Jesus’ disciples, he too was able to raise the dead, an ability which was, according to the Gospels, conferred on Christ’s disciple Peter who is said to have brought a dead man back to life by evoking Jesus’ name.

There are many examples of ‘miracles’ in the Christian Bible. The parting of the Red Sea and the extraction of water from a stone by Moses in the Old Testament, and Jesus walking on water, calming the weather and healing the sick and lame through touch being only a few. Moses, however, is not regarded as a “god” in the Christian, Moslem or Jewish religions. He is regarded as a “prophet”, and the miracles he performed were actually acts of God performed “through” Moses. Moses is thus an instrument, or servant, of God. Likewise, the miracles attributed to Jesus’ disciples (and subsequently 339

other followers), actually, according to Christian doctrine, occur only through divine intervention – direct action by God, via the ‘Holy Spirit’. God, however, is equated with Jesus, and many people pray not to God, but to ‘Jesus’. ‘God’ and ‘Jesus’ have become rival gods in a way that God and Moses have not. Of course, a rationalist view, and an objective scientific view necessitate scepticism regarding the Biblical miracles or any other records or reports of ‘miracles’. An objective approach necessitates consistent scepticism regarding any claim or explanation, but also the weighing up of different probabilities according to their merit whilst keeping an open mind. A closed mind cannot learn, cannot expand and cannot correct its false assumptions and delusions. A mind that is ‘too open’ – in the sense that it accepts things as true without due consideration and doubt – becomes gullible and prone to being misled. Minds can, of course, be both ‘closed’ and gullible at the same time, believing with unwarranted readiness (and/or confidence) things which suit their assumptions.

There are many books that have been written about miracles, some disputing their existence and others claiming their veracity and adding new ones to the list. Some, regarding the Biblical miracles, suggest that the fundamental philosophical messages of Christianity are sound (and maybe even sounder) without belief in miracles. They form, however, one of the edifices on which Church authority, and Catholic Church authority, in particular, is based. While the early Christians regarded all ‘believers’ as ‘saints’, and the word is used to describe especially virtuous people who are not ‘Christian’, the Catholic Church created a hierarchy of “Christian Saints” which rivalled the Hindu pantheon in number. Beginning with all Jesus’ disciples except Judas the Roman Church has systematically added to the official book of saints, predictably including several popes and other Catholic clerics, all of whom are said to have performed at least one “miracle”. It might cynically be said that St Paul created three ruling gods and placed Mt Olympus under the rule of the Father god, Yahweh, god of the Jews, and that Constantine made the Roman Empire rulers of Yahweh. The Roman Church added to the pantheon of subordinate deities (saints and angels) in ‘Heaven’ and added the horrors of Hell. Having deified Jesus, critic of the Jewish political and religious leaders (the Pharisees), the Roman Church persecuted Jews as the “killers of God”, or turned a blind eye while they were persecuted.

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The persecution and mass-murder of people today, as in the past, can be studied in terms of causality. What are the causes of persecution? What are the causes of humans killing other humans? To approach these important questions sensibly we must first define the terms “persecution” and “mass-murder”. In both cases the definition is compounded by questions of degree, The Oxford School Dictionary defines “persecute” as “treat cruelly, oppress, esp. because of religious beliefs; harass, worry”. How cruel (or oppressive) must treatment be to qualify as ‘persecution’? The Heinemann School Dictionary adds that the ill-treatment or harrassment must, to qualify as ‘persecution’ be “persistent”, in line with the Latin persequi (to pursue), from which the English word “persecute” is derived. By either definition the forced treatment of law-abiding citizens through CAT teams and CTOs would have to be considered as a modern example of persecution in Australia – a type a persecution with plenty of precedents. It is clear, from the first-hand accounts of survivors of forced psychiatric treatment in the UK, Canada, New Zealand and the USA that persecution through coercive psychiatry occurs throughout the English- speaking world, and victims of this persecution often come from non-English-speaking backgrounds, financially and educationally impoverished backgrounds, immigrant populations and racial minority groups. Unorthodox (‘heretical’) religious, philosophical, scientific and political beliefs are persecuted along with adherence to traditionally proscribed political and religious beliefs, such as Communism and Polytheism. The political persecution extends to people with anarchic views and ‘radical’ views regarding the State, National or World governments.

Before this is dismissed as an exaggeration, it is worth considering the many reasons people are given diagnoses of schizophrenia and manic-depression and the consequence of their not accepting the labels they are given. According to psychiatric texts, only 2 out every hundred people are given a diagnosis of schizophrenia or schizoaffective disorder in the USA, and not all of them refuse the label. The same is the case with ‘mania’ and ‘hypomania’ – many people accept that they have been mentally ill and that this illness is a ‘biological one’, like diabetes, as they are told in the plethora of “patient education” literature available in public hospitals and clinics. Some of those who resist the label of illness/madness resist it strongly, especially if they adhere to their beliefs strongly. The stronger they resist it, however, the more “assertive” is the treatment. If they quietly accept their tablets and admit that they are (or were) ill, they are treated with patronization and pity in the guise of “sympathy” but can avoid physical 341

violence. If they physically resist drugging the force used more than matches their resistance, and they are always outnumbered.

It should be stressed that most of the people who resist a diagnosis of schizophrenia are not being troubled by hallucinatory voices. Neither are hallucinatory voices necessarily harmful or dangerous, although they can be. Belief that one is God or the Messiah is also not necessarily harmful or dangerous, although, again, it can be. It depends on what the words “god” and “messiah” are taken to mean, and how the belief affects behaviour. Such beliefs are not, however, “normal”, in that most people do not hold these beliefs, and, by the same token, hearing disembodied voices is also not “normal”. According to current psychiatric theory and practice people hearing disembodied voices and those who believe themselves to be “the Messiah” are unequivocal candidates for forced psychiatric treatment with dopamine-blocking drugs if they refuse to take them voluntarily (or are suspected of not taking them). This forced treatment is supported by an elaborate system of laws, and policed by teams of psychiatric workers who are authorised to call on State Police to remove people from their homes for “assessment and treatment” in locked wards within public hospitals.

The word “psychiatry” is derived from the Greek psyche (mind/soul) and iatros (treatment). It refers, literally, to treatment of the mind. This treatment can be cruel or it can be kind. If it is cruel, it can be expected to compound existing problems (and can, moreover, be defined as torture). If it is kind, it can lead to relief of suffering and distress. Despite the popular idiom that “one must sometimes be cruel to be kind”, cruelty and kindness are opposites: it is not possible to treat someone cruelly and kindly at the same time. Neither is it necessary to be cruel to achieve therapeutic success, unless therapeutic success is defined as “compliance with the orders of the therapists”. If successful therapy is so defined, and, in the area of psychiatry it often is, then cruelty becomes a powerful tool for forcing upon the ‘patient’ the opinions and views of the therapist. In the case of ‘schizophrenia’ and ‘mania’ the ‘gaining of compliance’ is routinely ensured by incarceration, usually for several weeks, during which time the person is bombarded with ‘brainwashing’ propaganda. This includes repeated accusations by ‘nurses’, ‘psychologists’ and ‘social workers’ that they are “very ill” and need to take their “medication” and “do what their doctor tells them”. But what their doctors tell them cannot be relied upon – they are rarely told in advance of the toxic effects of dopamine blockers (tardive dyskinesia, akathisia, 342

parkinsonism etc); they are rarely, if ever, told the truth about the history of the label they are compelled to accept as “their illness’, be it “schizophrenia”, “schizoaffective disorder”, “manic- depression” or “personality disorder”. This omission is not surprising, since if the truth were to be revealed the patients (and their families) would undoubtedly refuse both the diagnoses and the long- term ingestion of dopamine-blockers (and drugs, generally).

Returning to the question of “informed consent”, how much historical detail about particular diagnoses and treatments is necessary to be truly “informed”? Modern society and modern medicine is infatuated with “new” and “current” ideas, and in the rush to get (or prescribe) the newest treatment caution is frequently thrown to the wind. This infatuation with the “new” is ruthlessly exploited by the pharmaceutical industry, which is not above claiming old (and discredited) drugs as “new” ones, merely by marketing them under new names. Propaganda falsely exhorting the benefits of psychiatric drugs litters the wards and waiting rooms of the public hospital system in Australia, some indirectly provided by the pharmaceutical industry via “stakeholder-organizations” such as the Mental Health Foundation, some actually provided by the Commonwealth Government as part of the multi-billion- dollar Mental Health Strategy, possibly the most disastrous public health strategy thus far inflicted on the Australian people.

The roots of the word “schizophrenia” are found in the Greek language and that of “dementia praecox”, the previous term given to the condition by Kraepelin, in Latin. Many words in the medical and scientific vocabulary, including “schizophrenia” originate in Greek and Latin roots, reflecting the cultural origins of the “Western medical education system”. The phrase “Western medical education” can be misleading and the polarisation between “Eastern and Western” models is dualistic (and simplistic), however it is a distinct system with a definite and uninterrupted history and hierarchy. It is not, however, the only medical education system in the world, although it is the one that has trained all the “medical practitioners” in Australia, including myself. It trains all the medical specialists, the medical researchers, the registered nurses the laboratory technicians and physiotherapists. It trains, or contributes significantly to the training of the occupational therapists, the social workers and the 343

psychologists, and is a massive global system. It is commonly referred to as “orthodox medicine”, and has been called the “allopathic disease model” and is the dominant paradigm of the “medical profession”, a profession controlled and partly in control of the “medical establishment”. The ‘medical establishment’ is, of course, not one establishment, but a complex and intricate system of establishments, intimately connected with the universities of nations around the world. These smaller establishments (subsets of the ‘global medical establishment’) are each comprised of one or more institutions, sometimes formally referred to as “institutes”, at others, “centres”, “departments”, “faculties” etc.

Each of these institutions teaches particular disciplines and subjects within these disciplines which contain certain assumptions. These confront the pre-existing belief system of the student to various degrees depending on what their pre-existing beliefs are, and how firmly they are held. Looked at in terms of delusions, the training a person is given in secondary and tertiary education can create them or destroy them. Inevitably it does both: destroys some delusions and creates others. This is the case if the beliefs acquired by the student are untrue, given a definition that “delusions are false beliefs” alternatively expressed as “beliefs contrary to reality”. A definition of delusions as “false, fixed, beliefs” makes little sense and is therapeutically harmful, since firstly, many potentially disastrous delusions may go unrecognised and secondly, less effort may be made to correct the delusion through discussion and debate because the task is thought to be hopeless.

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A CURE FOR SCHIZOPHRENIA!

Claiming to have a cure for schizophrenia is admitting to a medical heresy. Every psychiatry text insists that schizophrenia is incurable. But if schizophrenia is a misnomer it can be cured by rejection of the label – by patients and by therapists.

For those who hope for a “magic bullet” or “vaccination” against madness, my cure will be disappointing; some may not regard it as a cure at all because it does not come in chemical form. It is a cure based on logic and words and though it is a cure for schizophrenia it is not a cure for auditory hallucinations (one of the common reasons for the diagnosis). I believe, in fact, that dopamine- blockers, because of their effect on slowing down imagination and other creative mental processes, can be effective (in much smaller doses than are commonly used) in the successful treatment of auditory (and olfactory, and to a lesser degree, visual) hallucinations. Many people who periodically suffer from such hallucinations, if they find them disturbing, are more than happy to take medication (even medication with long term risks and dangers) to rid them of the problem. If they do not want their hallucinations treated it makes no more sense to force treatment on them than it does to forcibly inject a person with penicillin because they refuse to take antibiotics for tonsillitis or to forcibly operate on a person for appendicitis against resistance.

If talk therapies “do not work”, I believe doctors should look at the limits of their own skills of explanation, persuasion and suggestion. They should not allow themselves to become inquisitors or drug-dispensing automatons, and neither should nurses and other ‘health workers’. Health is the opposite of illness and all efforts by health workers should be directed towards the health and wellbeing of their ‘clients’ – supporting them and nourishing them, reinforcing healthy ideas and giving them ideas about how to become more healthy. If they become guards, drug-dispensers or torturers they preclude the right to respect from society (and from their prisoners, regardless of whether they are called ‘patients’ or ‘clients’), and the right to regard themselves as “health workers”. They must instead recognise themselves as part of the cause of schizophrenia, a recognition which will only occur with deep personal and professional insight. Unfortunately, deep analysis may reveal that they have been the unknowing accomplices of a system that is implementing systematic torture, and even 345

mass-murder (or mass-manslaughter at the least), leading to a strong disincentive to such inquiry. Critical “inward-looking” is, however, essential for personal development, including moral advancement. This is the case for individuals, as much as for organisations and institutions.

The first step, and the most important step, for the cure of schizophrenia is rejection of the label. This assertion is likely to be greeted with fury by the psychiatric profession, amidst cries of irresponsibility – surely I am not saying “schizophrenia does not exist”? Won’t this make all those people who need their medication stop taking it?

“Schizophrenia” is a label, first and foremost. It is a word, first coined by Eugen Bleuler, a Swiss psychiatrist (and medical doctor), in the early 1900s. While most psychiatrists agree that “schizophrenia” is a misnomer, and that people given this label do not actually have a “split mind” they continue to claim that “schizophrenia” is a distinct and definite “biological illness”. They are, in other words, claiming that, although “schizophrenia” presents differently in different people they all have the same underlying disease. A close examination of the criteria for the diagnosis of delusions and other ‘symptoms’ of schizophrenia reveal this as highly improbable, to say the least. There is no good scientific reason to regard a person who has auditory hallucinations as having the same illness as a person who believes that they are the reincarnation of Descartes (or Mary Magdalene, or Jesus). It makes no sense to describe a person with unreasonable views regarding reincarnation as having the same “mental illness” as a person with unreasonable views regarding telepathy. The fact that young people with bizarre views regarding reincarnation may have a tendency to develop bizarre views regarding telepathy can be far better explained by the learning experiences young people are subjected to, as demonstrated in the earlier analysis of New Age ideas (remembering that these ‘New Age’ ideas regarding reincarnation and telepathy are derived from ancient Eastern religious and philosophical beliefs).

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A major problem immediately confronts the person who wishes to reject a label of schizophrenia: the circular argument that “refusal of label” indicates “lack of insight”, indicating “relapse”. The rejection of the label, and especially the refusal to take drugs can be, and frequently is, punished by extended incarceration and change from voluntary ingestion to involuntary injection. This itself provides further evidence that “schizophrenia” is an iatrogenic illness.

Removing the label of schizophrenia is not an easy task, and a huge difference exists between that which must be achieved by patients and that which must be achieved by doctors for a lasting cure for schizophrenia. The task for patients is the easier of the two, but it is still not easy – it depends on how attached one is to the concept of schizophrenia, and how harshly the label-rejection is punished. In the case of doctors, including psychiatrists, (who can prevent the previous problem by not punishing their patients for rejecting a label of schizophrenia), depending on how many people they have injected with dopamine-blockers, and under what circumstances, they (and other health-care workers) can be predicted to resist the dismantling and dismissal of the concept of “schizophrenia”. Hospitals, universities, and, of course, drug companies can be expected to do the same. This, in itself is not a good reason for those who have been labelled with ‘schizophrenia’ to accept the label – since the above- mentioned can also be recognised to have a vested interest in the maintenance of the discredited concept.

The acknowledged misuse of the term “schizophrenia” by Soviet and Nazi psychiatry casts light, and doubt, on the scientific validity of the term, presenting clear evidence that, at least by these regimes, it has been corruptly used as an instrument for political control – in the case of Nazi Germany, for State- implemented mass-murder. The direct involvement of the Nazi psychiatrist Kurt Schneider in the development of post-WWII criteria for the diagnosis of schizophrenia (the ‘first-rank symptoms’) makes it difficult to respect the concept except with considerable selective blindness. Such selective blindness is, however, extremely common, and is worsened by the fact that the connections between the Nazi holocaust, Soviet repression and psychiatric practices in the “West” have been studiously ignored by psychiatric texts, even those claiming to present a or “the” history of psychiatry. A close 347

look at psychiatric treatment for ‘schizophrenia’ in the “West” and in Australia reveals this group of ‘seriously mental ill’ (‘psychotic’) people (who happen to present a convenient captive population for experimentation) to have been subjected to a series of extremely cruel treatments, the forced injection of neurotoxins and chemical restraints being only the most recent and widespread. They have been given electric shocks (without anaesthetic) – which can “make people talk” (hence remedy ‘catatonia’); they have been injected with potentially fatal infectious agents (notably malaria and typhoid); they have been made comatose for days or weeks at a time (with insulin, barbiturates, or other drugs); they have had parts of their brain destroyed – with surgical knives, electrical cauterization, or, at worst, ice- picks. Each treatment has been accompanied by false claims of their “effectiveness” by those who performed the treatments (psychiatrists), who have always been able to find a few compliant patients to vouch for how wonderful the respective treatment was.

Some people who have been diagnosed as having schizophrenia react angrily to debate about the validity of the term, and this is not surprising. After several years of treatment, ‘schizophrenia’ often becomes both a crutch and an excuse. Removing the label of schizophrenia means that the “disease” can no longer be blamed for whatever problems they have. It means that to become sane and cure their mental problems they need to use their own brains – there is no drug or immunization panacea, and none is likely in the future. It also means that the treatment they were given has been, at best, inadequate, and at worst, disastrous. The latter is not an uncommon view among diagnosed schizophrenics, even among those unwilling to challenge the label itself. Unfortunately, those gullible patients who fervently believe in the biological basis of the disease, and that the cure will come in the form of a ‘new drug’ become prime candidates for experimentation and further abuse. I must accept that my views may offend these people.

Another group who object strongly to the challenging of schizophrenia are the ‘families and carers’ of diagnosed schizophrenics. Forming the backbone of ‘the Schizophrenia Fellowship’ and other such ‘support organizations’, the families of schizophrenics also have a deep vested interest in perpetuation of the schizophrenia myth. The label has inevitably provided an inanimate entity to blame for various 348

problems in the past – avoiding the need to blame people, including themselves. The schizophrenia myth does, however, actively create scapegoats, and the development of genetic theories regarding its aetiology, the diagnosis of ‘schizophrenia’ in one family member places other members (including those yet unborn) at risk of stigma and inheriting the family ‘curse’. This inheritance need not be because of any genetic tendency – the fact that doctors (and others) see what they look for means that the diagnosis of ‘serious mental illness’ in one family member significantly increases the risk of their relatives acquiring a similar label.

In the case of doctors who have made diagnoses of schizophrenia, or concurred with them and injected people with dopamine-blockers in the conviction that these were necessary, an honest appraisal of the term is difficult, since it brings into question their medical competence and their understanding of the Hippocratic Oath. Many doctors have insisted on compliance with psychiatrically prescribed drug regimes even when they have recognised symptoms of brain damage from the drugs they were administering (notably tardive dyskinesia). Many have failed to defy specialist psychiatrists, even when they suspected (or knew) them to be over-prescribing potentially neurotoxic drugs, and many have failed to notice early (or even late) signs of neurological damage. This is unfortunate, but hardly a good reason to continue applying a label which can so clearly be demonstrated as psychologically, socially and physically (because of the drugs used) damaging.

The psychiatric profession itself has the power to invalidate the label of schizophrenia, but shows no signs of doing so. This branch of the medical profession, which can be compared with the high- priesthood of the Inquisition, defines what is regarded as acceptable and what is not in the area of “mental health” – not just in the case of people who voluntarily seek their help as physicians, but for society at large. The profession is highly intolerant of criticism from within or without (as was the Inquisition). Psychiatrists preside over “informal courts” with the power to inflict painful punishments (incarceration and injections), to strip people of their legal and financial rights and freedoms, and extract forced confessions (of ‘mental illness’) – again as did the inquisitors. The psychiatric profession is an elite and secretive organization, entered only through acquiescence to the ‘College of 349

Psychiatrists’ system of rules, regulations and doctrines and punishes those psychiatrists (and other doctors, as they are able) who subsequently turn against the system that trained them (bringing to mind, again, the Inquisition).

This work is likely to be greeted with a similar response to my previous criticisms of psychiatric diagnosis and practice – stony silence, or accusations that I am “anti-psychiatry”. Also, I am not a ‘qualified’ psychiatrist. I am not a member of the Royal Australian and New Zealand College of Psychiatry. I do not even have a special diploma in psychiatry. In fact, the only formal medical qualification I have is that of my basic medical degree – an MBBS obtained from the University of Queensland in 1983. Why listen to me?

While it is true that I have no specialist qualification in psychiatry, over the past five years I have researched the neurosciences extensively through cross-disciplinary reading and extensive discussions with hundreds of people, dozens of whom have been diagnosed with schizophrenia. Prior to that I spent 8 years in general practice which inevitably involves a considerable amount of psychiatry. It was through working as a family doctor that I recognised the importance of maintaining a holistic approach towards the diagnosis and treatment of health problems, and the limitations of the reductionist approach I was taught in medical school and the three years I worked in the public hospital system. During the 8 years I worked as a general practitioner I wrote thousands of scripts for psychoactive drugs – mainly antidepressants, benzodiazepine tranquillisers and sleeping tablets. I also wrote a few scripts for dopamine-blockers, always on request, and always to continue treatment instituted by other doctors – usually psychiatrists. On a few occasions I have personally injected people with depot preparations of dopamine-blockers, although never against a person’s will. This I did with some, but not full, knowledge of the risk of tardive dyskinesia etc: I believed that the benefits outweighed the risks. As I have learned more about the risks, my views have progressively changed.

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The second step for the cure of schizophrenia is to stop ingesting, injecting or prescribing dopamine-blockers, unless newer ‘atypical antipsychotics’ fail to control disturbing auditory (or other) hallucinations. In the past few years there have been some significant advances in drug therapy for auditory hallucinations which make the older dopamine-blockers largely redundant. These are currently being marketed as ‘atypical antipsychotics’ and are thought to cause significantly less side- effects than the older drugs. They are, however, still dangerous drugs and are already being over- prescribed; and they are also considerably more expensive than the older dopamine-blockers. These drugs, risperidone, olanzapine, aripiprazole and clozapine, are significantly different from the older agents, and are reported to cause fewer and milder adverse effects than haloperidol, chlorpromazine, and the other ‘old antipsychotics’. Importantly, they are expected to cause less tardive dyskinesia than their older rivals. Unfortunately, the politics of the pharmaceutical industry and its track record make considerable scepticism appropriate when evaluating such claims. New drugs are routinely promoted as the “newest and therefore the best”, always with the claim that they cause less problems than those they are to compete with – and these claims are frequently unjustified. Tardive dyskinesia can take years to appear, and other serious problems may not become evident until several decades have passed (increased risk of cancer, for example).

It is a fundamental and general principle of good medical practice to prescribe drugs in the smallest effective dose and for the minimum necessary period to achieve a cure. This is not a principle that should be deviated from too readily – yet in the area of psychiatry it routinely is. While few doubt the value of antibiotics in the treatment of serious bacterial infections, no sensible and ethical doctor would suggest that people take antibiotics for years after suffering from an infection so as to prevent further infections. If he or she did, it would soon become evident that this firstly does not achieve the desired protection (from infection) and secondly, that it causes health problems from the antibiotics themselves. This is equally true in the case of psychoactive drugs, and as in the case of antibiotics, why this should be so is clear from the pharmaco-physiology of psychoactive drugs.

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All psychoactive drugs affect brain chemistry – this is obviously what they are supposed to do. They specifically affect neurotransmitters, chemical messengers in the brain which enable communication between neurones (brain cells) at synapses (junctions between neuronal processes known as axons and dendrons). There are several known neurotransmitters, and much is known about their biochemistry and activity on a cellular level, especially the catecholamines – dopamine, noradrenaline and adrenaline. We know that neurones (and other cells) have specific protein receptors on their cell membranes, and that by binding with these receptors, neurotransmitters affect the activity of nerve cells – and ultimately of the whole brain. While it is nonsense to claim that humans are just a mass of chemicals, or that complex behavior can be explained just on the basis of chemicals (or chemical imbalances), it cannot be denied that chemicals, both those produced naturally by the body and those introduced into, it can profoundly affect mental and physical health. If it is accepted that thought is produced by the brain (and it may not be), neurotransmitters are necessary for any thought, because brains cannot work without neurotransmitters crossing synapses and binding to receptors.

Neurotransmitters have formed a central focus of psychiatric and pharmacological research (which is often combined) since the first isolated neurotransmitter, acetyl choline, was identified by Otto Loewi in 1926. Professor Loewi was professor of pharmacology at the University of Graz, in Austria. He began his work in 1921, only a few years after the end of the first World War and the collapse of the rule of the Austrian Hapsburg Empire, which for hundreds of years was known as the “Holy Roman Empire”. In 1938 Austria became, temporarily, part of the German Nazi Empire. Austria was, of course, home to the most famous (or infamous) of psychiatrists – Sigmund Freud. Freud was one of many Jewish psychiatrists who fled Nazi persecution and escaped the eugenics monster which the psychiatric profession had played such a central role in creating. Another Jewish psychiatrist who escaped persecution by the Nazis was Heinz Lehmann, who fled to Canada, where he was employed in Montreal’s Verdun Protestant Hospital. Edward Shorter, in A History of Psychiatry (1997) describes some of the treatments Lehman tried out when he arrived in Canada. These give some indication of what was going on in European psychiatric hospitals before and during the Second World War, and show that similar activities were occurring in Commonwealth nations too: 352

“In 1937, Heinz Lehmann, a refugee psychiatrist from Berlin, had just arrived at Montreal’s Verdun Protestant Hospital, where he was one of a few physicians for some 1,600 psychiatric patients. ‘It was pretty horrible to work under those conditions,’ Lehman said. ‘So I did all kinds of things, always convinced that psychotic conditions and the major affective disorders…had some sort of a biological substrate. I kept experimenting with all kinds of drugs, for instance, large doses, very large doses of caffeine, I remember, in one or two stuporose catatonic schizophrenics – of course, with no results’. He injected sulfur suspended in oil into his patients, ‘which was painful and caused a fever.’ He injected typhoid antitoxin to produce a fever analogous to the malaria therapy. ‘Nothing helped; I even injected turpentine into the abdominal muscles which produced – and was supposed to produce – a huge sterile abscess and marked leucocytosis [raised white blood cell count]. Of course, that abscess had to be opened in the operating room under sterile conditions. None of this had any effect, but all of this had been proposed in, mostly, European work as being of help in schizophrenia’.” (p.247)

Professor Shorter, professor of medical history at the University of Toronto, in Canada, is loath to condemn Dr Lehmann and his horrible experiments (in Canada). He argues that:

“The point is not that researchers such as Lehmann behaved inhumanely with their patients: They were searching in the best of faith for something better to offer them. It is rather that, by the time in 1951 that Henri Laborit, a surgeon in the French navy, began experimenting with a curious new ‘potentiator’ of anaesthetics, the ground had already been well prepared for the reception of new antipsychotic drugs. Laborit himself was directly responsible for a drug that changed the face of psychiatry: chlorpromazine.” (p.248)

Far from criticising the bizarre treatments of Dr Lehmann, Shorter presents them as being done “in the best of faith” and in the interests of his patients. He credits Lehmann’s work as helping ‘prepare the ground’ for new anti-psychotic drugs, and describes chlorpromazine as a ‘drug that changed the face of psychiatry’. Chlorpromazine, currently marketed as Largactil in Australia and Thorazine in the USA, was the first dopamine-blocker and became the ‘benchmark’ for subsequent anti-psychotics to be compared with. Most patients who have been given chlorpromazine would agree that it is a terrible 353

drug, and many doctors would agree as well. Some might add, though, that it is better than ‘whips and chains’, assuming these to be the treatments given to psychotic people before the advent of dopamine- blockers.

Before discussing the neurotransmitters and drugs which affect them we might pause to reflect on the experimental treatments for schizophrenia conducted by Dr Lehmann, who went on to become the Chair of McGill University’s department of psychiatry and receive many honours including the Order of Canada. What can Lehmann’s experiments teach us about modern psychiatry and the profession’s view of itself? Is it true that Dr Lehmann acted in “the best of faith”? If so, what other cruel treatments might be justified by the same argument? Knocking out the front teeth to let madness out through the mouth; causing sores to allow harmful ‘humours’ to leave through the skin; removing the uterus to cure ‘hysteria’? In fact the assertion that Lehmann acted in the ‘best of faith’ is made questionable by his own claim that (assuming he has not been misquoted), “It was pretty horrible to work under those conditions so I did all kinds of things…” Working in a crowded asylum is surely no worse than being forced to live in one. Lehmann admits that he was “always convinced that psychotic conditions had some sort of biological substrate”, despite repeated failures in effecting cures through the various experimental treatments he had learned were being tried out in Europe. It is difficult to imagine why injecting turpentine to cause a sterile abscess could be expected to cause improvement in mental health, and yet he says this was the specific intent of the experiment. It was supposed to cause an abscess. Shorter shows little interest in the ethics or the logic of Dr Lehmann, but gives the impression he regards both as reasonable. He accepts the term “stuporose catatonic schizophrenics”. He quotes, without questioning the assertion, Dr Lehmann’s claim that “none of this had any effect”. It is doubtless true that none of these experimental treatments had any healing (genuinely ‘therapeutic’) effect, but definitely untrue that they had no effect. They caused suffering and illness – for a painful abscess cannot be regarded otherwise. Dr Lehmann’s insistence on continuing these abusive experiments suggests a delusional conviction in the “biological substrate”, by which he really means a chemical substrate, he believed lay at the root of psychosis.

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Professor Shorter describes the experiments of Heinz Lehmann in an introduction to “the first drug that worked” (chlorpromazine, in Professor Shorter’s assessment) in a chapter titled “The Second Biological Psychiatry”. He introduces the resurgence of modern “biological psychiatry” (of which he is clearly an admirer and ardent advocate) thus:

“In the 1970s, biological psychiatry came roaring back on stage, displacing psychoanalysis as the dominant paradigm and returning psychiatry to the fold of the other medical specialties. The triumph of the biological, the view that major psychiatric illness rested on a substrate of disordered brain chemistry and development, meant a return to themes that had last resounded in the nineteenth century at the time of the first biological psychiatry. It also entailed a repudiation of the psychoanalytic paradigm that saw psychiatric illness as psychogenic, arising in the mind as a result of faulty child rearing or environmental stress, curable through in-depth psychotherapy. There was room in the biological paradigm for psychotherapy, but it was the kind of informal psychotherapy inherent in the doctor-patient relationship and not the elaborate choreography of working through unconscious conflicts that psychoanalysis scripted.” (p.239)

Taken literally it is difficult to fault the concept of “biological psychiatry” and I would like to think that my own work is good biological psychiatry. The term “biology” is derived from the Greek bios (life) and logos (word). This makes ‘biology’ the scientific study of life (and living things) and ‘biological psychiatry’ a worthy aspiration indeed: treatment of the mind using biological knowledge. For such treatment of the mind to qualify as “therapeutic” it must, of course, be directed towards healing and the creation of health. The success of therapy can be judged objectively, and can be gauged by how well people become, how long it takes for them to become well, and how many people become well through the treatment. These are not easy things to measure, however, and more nebulous concepts such as “quality of life” are even more so. Nevertheless thousands of people around the world spend their days compiling statistics on ‘quality of life’ based on various questionnaires each founded on contentious assumptions, and the World Health Organization changes its priorities accordingly. Professor David Copalov, Director of the Mental Health Research Institute in Melbourne since 1985, and professor of psychiatry at both the University of Melbourne and Monash University, is an acknowledged Australian 355

expert on schizophrenia, and authored the chapter titled “Biological Therapies” in Foundations of Clinical Psychiatry (1994).

His opening words in the chapter indicate a very different conception of ‘biology’ to that of “the scientific study of life”:

“Most patients with mild psychological disorders can and should be treated without recourse to biological therapies. However, for many with moderately severe disorders and for all of marked severity, such therapies are important components of management.” (p.376)

Professor Copalov reveals how far he has strayed from a holistic (or accurate) understanding of biology:

“Biological therapies, which include drugs, electroconvulsive therapy and psychosurgery, seek to control symptoms by readjusting neurochemical processes which are assumed to be perturbed in psychiatric disorders. Interestingly, their use still occurs in ignorance of specific neurochemical pathogenesis. Most of the knowledge accumulated about neurotransmitter dysfunction, for example in depression and schizophrenia, derives from establishing that particular drugs are effective in treatment and then working out their effect on neurotransmitter systems. It has been shown that all effective anti-schizophrenic drugs block dopamine neurotransmission and that most antidepressant drugs augment noradrenergic and serotonergic neurotransmission. Working back from these facts, researchers have postulated that dopaminergic neurotransmission is increased in schizophrenia, and that noradrenergic and serotonergic neurotransmission is impaired in depression.” (p.376)

Professor Shorter writes of the “triumph” of “biological psychiatry” over psychoanalysis (by which he means Freudian psychoanalysis) and that within this “paradigm” there was room ‘only’ for “the kind of informal psychotherapy inherent in the doctor-patient relationship”. It was in line with this view (and 356

with the same false assumptions) that Dr Brian Davies advised training doctors that “psychotherapy proper” is contraindicated for people with “schizophrenia”. Dr Davies did, however, agree that “supportive care” by an “interested doctor” can minimise “social and personal problems”. In fact, if social and personal problems are truly minimised, the condition of ‘chronic schizophrenia’ may well disappear. Earlier, Dr Davies describes “supportive psychotherapy” (which, he says, non-psychiatrists should limit themselves to) as including “interested listening, environmental manipulation, explanations, reassurance, advice, persuasion and re-education”. I would argue that these components are the foundations of good psychotherapy any physician and, more than qualifying as “proper psychotherapy”, if psychiatrists, too, limited their “psychotherapy” to (genuinely) “supportive psychotherapy”, the problems which have necessitated this work would never have arisen. “Supportive psychotherapy” is, as Professor Shorter correctly assumes, essential for good medical care, but it is not “inherent in the doctor-patient relationship” – as far as usual (and institutionally-taught) doctor-patient relationships are concerned. The traditional “doctor-patient relationship” has very much been a case of doctors giving orders and patients doing what they are told. While this has changed considerably in recent years, the authoritarian structure and assumptions of the medical establishment are still clearly evident. They are evident even in the tone used by the educators of the doctors – as seen in the textbooks medical students are taught from.

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Figure 2: Progression from delusion to perception of reality

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This diagram (fig.2) illustrates a theoretical framework through which individual and shared delusions can be identified, challenged and dispelled. ‘Delusional beliefs’ are taken as meaning any factually incorrect beliefs and are contrasted with beliefs that are truly representative of reality. Knowledge is taken as meaning factually correct information as well as knowledge arrived at through reason and logic. The accumulation of knowledge, so defined, is theorised to facilitate wisdom and intellectual growth. The point of the diagram, when I drew it (in 1996) was to illustrate that the recognition of delusions and the correction of delusional beliefs are important requirements for the attainment of true sanity – and thus true mental health. The questions in the lower right hand corner illustrate my own quest for truth and certainty, particularly in the area of medical science, but also in politics, history, sociology, psychology, anthropology, philosophy and life:

1. Is it true?

2. On what basis do I believe it to be true?

3. Is it relative truth or absolute truth?

4. Is it likely? (certainty vs. theory vs. hypothesis)

5. How likely is it? (probability and statistics)

6. Is it logical?

7. How does it link with other knowledge/beliefs?

8. Are there any contradictions?

9. How can they be resolved?

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The purpose of these questions is obviously to examine degrees of certainty with which particular beliefs are held. These can range from absolute (100%) certainty that a given idea or belief is true (correct) to complete (100%) certainty that it is false (incorrect). True facts are taken as those congruent with reality, and it is theorised that these facts can be arrived at through logical thought processes. The diagram suggests that a ‘fact’ cannot be both true and false at the same time, and was a conscious attempt to elucidate competing scientific and philosophical claims, as well as claims of ‘paradoxical phenomena’.

On the top right hand side of the diagram is a list of common ‘shared delusional beliefs’ (which are equally valid as a list of shared factual beliefs) including religious, cultural, familial, intradisciplinary, national, political, economic and social beliefs. This is in contrast to the common psychiatric dogma that shared delusions are uncommon – and usually shared by only 2 or 3 people. Such delusions have been given specific labels – folie a deux and folie a troix for delusions shared by, respectively, two or three people. Shared delusions including hundreds, thousands or millions of people are not discussed in psychiatric texts, as a rule. If they were, the curious situation would necessarily arise where the psychiatric profession diagnosed itself as deluded. They would not, though, be the only profession that would have to do so – intra-disciplinary delusions are ubiquitous.

A psychiatrist once told me that the problem with what medical students learn in university is that about half of what they are told is true, half is false, but no one knows which half. Another informed me that he regarded himself more as an artist than a scientist – and he was talking about the art of psychiatry (supposedly a scientific discipline). Yet another said he was uncertain about the existence of his own heart and the real existence of the people he was treating, because he adhered to the dogma that one cannot be certain about anything. A fourth psychiatrist, a senior professor at a teaching hospital insisted that the cliche “there is no such thing as a new idea” is literally true. At the time I was reading a book on Charles Darwin by the evolutionary biologist Robert Wright, which I had in my hand. I suggested the concept of evolution by natural selection as being an example of an idea that was, at one stage, new. The professor, assuming that I was referring to Darwin, said, “the ancient Greeks 360

believed in evolution, you know…It was thought of a long time before Darwin”. When pressed on who first thought of it (before the Greeks), the professor could only answer, “Well, it all goes back to Adam and Eve, doesn’t it?”

The questioning of “first causes” (or origins, or sources) of ideas inevitably leads into matters of philosophy, and specifically the branch of philosophy called “epistemology”. Epistemology, from the Greek epistole (letter) and logos (word) is defined in the Heinemann Australian Dictionary as “the study, investigation or theory of human knowledge” – by this definition surely one of the most important areas of philosophy and science. Without understanding the basics of epistemology it is impossible to ascertain the validity of information and beliefs, be they scientific, political or personal. This can, of course, be done without using, or thinking in terms of, the concept of ‘epistemology’. Nevertheless the ‘epistemological processes’ of questioning assumptions, critically examining lines of argument involved in inductive and deductive reasoning, inquiry about the sources of information and clarity regarding definition are important for clarity in thought and communication, and important if we are to know what to believe and what to disbelieve.

Figure 2 depicts the progression of a person (labelled ‘person C’ and whose belief system is depicted as a circle) from a state of delusion to a state of ‘supersanity’. The term ‘supersanity’ is a theoretical state in which all beliefs held in the mind are correct, and has not, to my knowledge, been achieved by anyone, ever. It provides, however, an ideal to work towards, and, because the total amount of knowledge (about the universe) is close enough to infinite, continued learning is possible throughout life, by which wisdom and knowledge can be predicted to keep growing.

Person B in the Venn diagram has a belief system that includes some beliefs shared with persons C, D and A. These are represented by the parts of the respective circles that overlap. The shaded area in the middle of the diagram thus represents shared delusional beliefs, while the overlapping areas within the 361

perimeter of the reality boundary depict shared correct beliefs (beliefs congruent with reality). Most, if not all, people have some correct and some incorrect beliefs, and no one really fits the theoretical constructs of Person A (totally deluded – having a ‘totally incorrect collection of beliefs’). It is theoretically possible that somewhere in the world exists a person who believes nothing that is false, and every belief he or she holds is true. Such a person is represented by Person D, who has been described as having “a small but ‘sane’ knowledge”. I have never met such a person, and doubt if he or she exists, however even such a person will always have more to learn, and by acquiring more knowledge (true knowledge as opposed to information per se) can be predicted, like Person C, to increase in wisdom, though not necessarily in ‘sanity’ (this has already been achieved if all beliefs are correct).

This model makes some assumptions that might well be questioned. The first is that increasing factually correct beliefs and sorting out truth from falsehood increases sanity and wisdom together with correcting delusions – and that correcting shared and individual delusions itself leads to improved mental health. The second is that a broadening paradigm and increased knowledge (within reality) leads to both wisdom and intellectual growth, and that resolving the ‘questions of epistemology’ on the right hand lower corner facilitates the movement of the mind in the direction of wisdom and intellectual growth (as well as greater sanity or mental health). A third questionable assumption is that logical beliefs are necessarily healthy beliefs, and a fourth that facts can be neatly divided into those that are true and those that are false. What about true paradoxes?

The 1976 edition of the Concise Oxford Dictionary, which defines “epistemology” as “theory of the method or grounds of knowledge”, gives several alternative meanings for the word “paradox”, none of which quite fit its modern scientific and medical use:

“paradox n. Statement contrary to accepted opinion; seemingly absurd though perhaps actually well-founded statement (HYDROSTATIC paradox); self-contradictory or essentially absurd 362

statement; person or thing conflicting with preconceived notions of what is reasonable or possible; paradoxical quality or character.”

A well-known scientific paradox is the dual wave and particle nature of light and other electromagnetic radiation. Easily demonstrated by slit lamp experiments, this physics paradox has long puzzled scientists – but they have had to accept that light behaves both as a wave and a particle (but not at the same time – in other words, it behaves sometimes as a wave and sometimes as a particle). Scientific thought and acceptance of paradox are, however, generally antithetical. Seemingly contradictory statements and genuinely contradictory statements (or beliefs) can remain unexplored and unresolved by the over-ready acceptance of “paradox” as an explanation rather than an observation that remains to be explained. This is especially the case in medical science and psychiatry, but also with philosophy, more generally. The use of amphetamines for the treatment of ‘hyperactive’ children, still taught to doctors as a ‘classic’ example of a “paradoxical therapeutic effect”, can be used to illustrate this point.

As a medical student at the University of Queensland in the early 1980s I was taught that about one in two hundred children (0.5%) had a “medical condition” termed “hyperactivity”, and that, for unknown reasons, these children exhibited a “paradoxical response” to stimulant drugs such as amphetamines. The paradox lay in the observation that they ‘slowed down’ instead of ‘speeding up’ (as one might have expected) when given amphetamines (commonly referred to as ‘speed’). At the time I accepted this as fact, but I took particular notice of the tutor cautioning us that most of the children suspected of being hyperactive by their parents are not “genuinely hyperactive” and thus not in need of amphetamines or other psychoactive drugs. I accepted the ideas that “genuine hyperactivity” exists as a medical condition, and that stimulant drugs can help in their treatment; and I was prepared to concur with specialist paediatricians or psychiatrists who had made such a diagnosis and prescribed methylphenidate (Ritalin) or dexamphetamine. I never made a diagnosis of ‘hyperactivity’ myself, however, and discouraged many parents from labelling their children as hyperactive rather than ‘highly active’. When I studied medicine it was also common for demanding children to be regarded as “attention-seekers”, a term frequently used, at the time, in the community and not uncommon among 363

school-teachers in referring to ‘naughty’ children (see page 55, regarding the origin of the label). After several years in general practice it became evident to me that it is perfectly natural for children to seek attention, and love. Many of the children who were obviously seeking attention from their parents were not being given much, or were being given attention for the very behaviour that irritated their parents (or teachers).

I also gathered that many adults also seek attention, and that individual members of a family may compete with each other for attention. Siblings may compete with each other, and parents may compete with each other for the attention (and respect and love) of their children. Equally, parents may compete with their children for the attention of their spouse – or others. Needless to say, more parents came to me wondering if their children were hyperactive than children wondering if their parents were neglecting their social, emotional and intellectual needs. Many more parents wondered if there was something wrong with their children than wondered if there was something wrong with themselves or their parenting. This problem confronts many family doctors and psychiatrists – that of parents looking for experts to validate their ‘diagnosis’ of particular ‘difficult’ children with the labels they have heard of.

At the time I started working as a doctor, the commonest diagnosis for ‘difficult children’ was “hyperactivity” and this was made relatively infrequently – less than 1% of children were said, in medical textbooks, to suffer from this problem. This changed suddenly in the 1990s with the launch of two new psychiatric labels, and a changed marketing strategy for stimulant drugs by their European and American manufacturers. The new labels were “Attention Deficit Disorder (ADD)” and “Attention Deficit/Hyperactivity Disorder (AD/HD)” but the drugs remained the same – methylphenidate (Ritalin) and dexamphetamine. By suddenly broadening the criteria for diagnosis of “hyperactivity” the market for these drugs exploded, as could be (and doubtless was) predicted.

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The terms “Attention Deficit Disorder” and “Attention Deficit/Hyperactivity Disorder” are generally used interchangeably, as are their acronyms (ADD and AD/HD). The American Psychiatric Association (APA) officially sanctioned the term “Attention Deficit/Hyperactivity Disorder” in 1994 in the DSM IV combining features defined previously as characteristic of Attention Deficit Disorder with those said to be demonstrated by ‘hyperactive children’ – and adding new proscribed behaviours to an already long list. This is the new ‘symptom construct’ for the diagnosis of AD/HD, which opens the section in the widely quoted textbook on “Attention-Deficit and Disruptive Behavior Disorders”:

“The essential feature of Attention-Deficit/Hyperactivity Disorder is a persistent pattern of inattention and/or hyperactivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. (Criterion A). Some hyperactive-impulsive or inattentive symptoms that cause impairment must have been present before 7 years of age, although many individuals are diagnosed after the symptoms have been present for a number of years (Criterion B). Some impairment from the symptoms must be present in at least two settings (e.g., at home and at school or work) (Criterion C). There must be clear evidence of interference with developmentally appropriate social, academic, or occupational functioning (Criterion D). The disturbance does not occur exclusively during the course of a Pervasive Development Disorder, Schizophrenia, or other Psychotic Disorder and is not better accounted for by another mental disorder (e.g., a Mood Disorder, Anxiety Disorder, Dissociative Disorder, or Personality Disorder) (Criterion E). (p.78)

Only by looking at the specifics can the full problem be appreciated – the details of what is to be regarded as ‘hyperactivity’ and ‘impulsivity’ give much cause for concern to anyone who abhors adults ‘ganging up’ against children. “Impulsivity” is to be diagnosed, according to the DSM IV, for the following reasons:

“Impulsivity manifests itself as impatience, difficulty in delaying responses, blurting out answers before questions have been completed (Criterion A2g), difficulty awaiting one’s turn (Criterion A2h), and frequently interrupting or intruding on others to the point of causing difficulties in social, academic or occupational settings (Criterion A2i). Others may complain 365

that they cannot get a word in edgewise. Individuals with this disorder typically make comments out of turn, fail to listen to directions, initiate conversations at inappropriate times, interrupt each other excessively, intrude on others, grab objects from others, touch things they are not supposed to touch, and clown around.” (p.79)

The other key diagnostic feature, “hyperactivity”, is evidenced, according to the DSM IV, by a similarly wide range of ‘misbehaviours’:

“Hyperactivity may be manifested by fidgetiness or squirming in one’s seat (Criterion A2a), by not remaining seated when expected to do so (Criterion A2b), by excessive running or climbing in situations where it is inappropriate (Criterion A2c), by having difficulty playing or engaging quietly in leisure activities (Criterion A2d), by appearing to be often “on the go” or as if “driven by a motor” (Criterion A2e), or by talking excessively (Criterion A2f).” (p.79)

It appears that the psychiatrists of the APA retain the belief that ‘children should be seen but not heard’. The textbook gives further details of what “toddlers and preschoolers with this disorder” do and what to expect in school age children:

“Toddlers and preschoolers with this disorder differ from normally active young children by being constantly on the go and into everything; they dart back and forth, are ‘out of the door before their coat is on,’ jump or climb on furniture, run through the house and have difficulty participating in sedentary group activities in preschool classes (e.g., listening to a story). School-age children display similar behaviors but usually with less frequency or intensity than toddlers and preschoolers. They have difficulty remaining seated, get up frequently, and squirm in, or hang on the edge of, their seat. They fidget with objects, tap their hands, and shake their feet or legs excessively. They often get up from the table during meals, while watching television or while doing homework; they talk excessively; and they make excessive noise during quiet activities.” (p.79)

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It is not surprising, given this long list of proscribed behaviours (including many typical of boredom), that the number of children (and adults) eligible for diagnosis of “attention deficit disorder” and drug treatment increased dramatically in 1994 with the publication of the DSM IV, which then became the “authoritative source” for numerous other articles and books that promoted the diagnosis (and its drug treatment) to parents, teachers and therapists. One such article was published in Modern Medicine of Australia in March 1998. Titled “Attention deficit hyperactivity disorder: clearing the confusion”, the article was authored by Dr Christopher Green, consultant paediatrician and author of the popular parenting book Toddler Taming. It was followed by a short questionnaire which, when answered, could be submitted by doctors for Continued Medical Education (CME) points.

The CME program is the official general practice training program of the Royal Australian College of General Practitioners (RACGP). General Practitioners (GPs or family doctors) in Australia who fulfil CME requirements are eligible to claim what has been termed “vocational registration”. This allows them to claim higher rebates under the medicare system than non-vocationally registered GPs. The vocational registration system, which is ostensibly designed to provide a financial incentive for family doctors to keep “up to date”, is administered by the RACGP, however, the sponsorship of CME credited activities more often than not comes from the pharmaceutical industry. Such is the case with the CME questionnaire on ADHD by Dr Green, since Modern Medicine of Australia is produced by the pharmaceutical industry (the ADIS press).

To gain the desired CME point doctors have to fill out a “computer answer form” and submit it to the “Modern Medicine Data Processing Department” in New South Wales. Doctors who score over 75% are automatically granted 1 CME point. They need 30 per year to maintain their vocational registration (plus some other minor requirements). The questions they need to answer are not ones designed to stimulate critical thinking: they are either multiple choice or, more usually, ‘true-false’ answers. Providing the simplest of tasks for general practitioners, the “required answers” are always provided in the article immediately preceding the questionnaire. Giving the “correct answer” requires one only to read the article and concur with what is said by the nominated ‘expert’. Any disagreement with the stated opinion is taken as an ‘incorrect answer’. Furthermore, the questions themselves serve the function of reinforcing certain ideas in the minds of doctors – which happens to suit the pecuniary 367

interests of the pharmaceutical industry as a whole. The ‘questions’ on AD/HD following Christopher Green’s article in Modern Medicine of Australia are actually statements, each of which is to be marked as either “true” or “false”. These statements are:

1. It is more common in boys than girls. [supposedly true]

2. ADHD affects approximately one in 1,000 school-age children. [false]

3. About 60% of affected children will carry some symptoms into adulthood. [apparently true]

4. The first behaviours of ADHD are usually apparent before the age of four years.

5. Children with ADHD usually require assessment and treatment before they start school.

6. The presentation varies considerably.

7. At least half of those with ADHD have at least one associated comorbid condition. [apparently true – they are often given multiple labels]

8. Less than 2% of children with ADHD have a specific learning disability. [apparently false – the text claims 50% have such disability]

9. When ADHD manifests with difficult, most parents present a restless, intrusive, unthinking child. [a direct quote from the text]

10. A diagnosis of depression excludes the possibility of ADHD. [false]

11. The condition is strongly hereditary. [supposedly true]

12. Food additives are the major cause of ADHD. [apparently false] 368

13. The majority of children with ADHD present with a mixture of behaviour and learning difficulties.

14. The diagnosis of ADHD can be dismissed if a child shows no obvious attention or behaviour problems at presentation in the doctor’s office.

15. Formal tests are required to make an accurate diagnosis of ADHD.

16. Stimulant medications are effective in 80% of cases. [supposedly true]

17. Sugar should be avoided. [the text claims this to be false]

18. A child with ADHD should be treated as any other child at school, with no special accommodation or allowances in the normal class.

19. Children with ADHD should be encouraged to try a variety of sports and hobbies. [true – and the only concession to non-drug approaches]

20. Clonidine is useful when stimulants do not adequately control a child’s impulsivity and overactivity. [apparently true]

These are the statements that doctors are invited to think about in what purports to be an exercise in “clearing the confusion” about “attention deficit hyperactivity disorder”. The twenty statements are divided into four groups, two on the “disorder” itself (statements 1-5 and 11-15), one on its “manifestations” (statements 6-10) and one on its “management” (statements 16-20). All the questions assume the validity of the label and its “biological origin” (rather than psychiatric origin) and the last five questions demand that doctors accept the efficacy of drug treatment with stimulant drugs. The “correct answers” are provided in the text. Dr Green writes, in the section on “medication”: 369

“The main medications used in ADHD are the stimulants dexamphetamine (Dexamphetamine tablets) and methyphenidate (Ritalin). These drugs have been shown to be effective in the short to medium term in over 80% of children with ADHD. There is still a lack of data on the long term benefits [long term risks are not mentioned]. Some important points regarding the use of stimulant medications in ADHD are outlined in the box on page 125.

“Other nonstimulant drugs – for example, clonidine (Catapres) and imipramine (Melipramine, Tofranil) – are also used, either alone or in combination. Clonidine is of particular use when stimulants are unable to adequately control a child’s impulsivity and overactivity. It is also used for children who have a major problem settling to sleep. Imipramine [a tricyclic antidepressant first developed in the 1950s] is the second-line drug which helps behaviour and attention when the stimulants are shown to be ineffective [the possibility of stimulants being harmful is not mentioned]. The nonstimulants are not without their risks and must be used cautiously. There are particular dangers with accidental overdose [or intentional overdose, which is not mentioned, despite a rising rate of child and adolescent suicide], so they must be given correctly and stored securely.”

The most obvious concern, that of creating addiction to stimulants in children, is vehemently denied by Dr Green in the “box on page 125”, but his denial rings hollow and is based on rhetoric rather than logic:

“Addiction has not been described in children with correctly diagnosed ADHD. Stimulants help them focus and bring them into reality. Humans don’t get addicted to reality.” (p.125)

He also refutes evidence of long term damage from stimulant drugs by either claiming that such evidence does not exist, or by claiming that the evidence has now been “dismissed”. The overall message regarding the safety and efficacy of drug treatment, though false, is made explicitly – but no sources for the pro-drug claims are mentioned. The pro-drug message is encapsulated in the box, 370

highlighted in point form for easy reading and ready recollection. These are the points given regarding “side effects”:

 The most common side effect when starting medication is for the child to become withdrawn, teary and irritable. This occurs only at the time of commencing medication or raising the dose. It is rarely a problem when medication is introduced gradually and both preparations [methylphenidate and dexamphetamine] are trialled.

 Many children report reduced appetite and some find it more difficult to settle to sleep. These and other side effects rarely cause trouble when the doctor trials both drugs and fine-tunes the dose carefully.

 In the past it was believed that stimulants reduced the child’s growth rate, but this claim has now been dismissed [why, and by whom, is not said].

 Although long term side effects are not a concern, the benefits of long-term therapy are still to be conclusively proven.

The next point on the list is the one quoted previously which denies that drug treatment with stimulants promotes addiction, claiming instead that “addiction has not been described in children with correctly diagnosed ADHD”. This is simply untrue. The fact that stimulant drugs, and especially amphetamines, are addictive has been known for many decades. That dexamphetamine tablets are addictive was admitted in the 1992 MIMS Annual by no less an authority than the very manufacturers of dexamphetamine tablets – Sigma Pharmaceuticals:

“Repeated use of dexamphetamine may cause dependence of the amphetamine type; its use to overcome fatigue or to extend wakefulness is, therefore, unadvisable.” (p.3-219)

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Ciba-Geigy (now Novartis Pharmaceuticals), the manufacturers and marketers of Ritalin (methylphenidate) gave a similar warning in the same text:

“As with other stimulants, the possibility of habituation or abuse must be considered, particularly in long-term therapy or in emotionally unstable patients and those with a history of drug dependence. Strict medical supervision is therefore recommended, especially if Ritalin is used for prolonged periods, e.g. minimal brain dysfunction.” (p.3-219)

The prescribing information for Ritalin in 1992 listed the indications for use of the drug as “mild depression”, “apathetic or withdrawn senile behaviour”, “narcolepsy” and “chronic fatigue”. “Attention deficit disorder” and “attention deficit hyperactivity disorder” are not mentioned – these names had not then been created, but “hyperactivity” and so-called “minimal brain dysfunction” had. The prescribing information claims, rather ambiguously:

“The use of Ritalin has been reported in hyperkinetic behavioural disorders in children attributable to so called minimal brain dysfunction. The beneficial paradoxical effect is similar to that previously recognised with other central stimulant drugs [notably amphetamines].” (p. 3-219) (emphasis added)

Even the MIMS Annual, published by the pharmaceutical industry, has to admit, by using the phrase “so called”, that there was no real evidence of “brain dysfunction” in the children who were thus labelled (it was inferred because of their supposedly ‘dysfunctional behaviour’). This is a serious accusation – brain dysfunction means, literally, that there is something wrong with their brains, rather than something offensive (to adults) about their behaviour. Minimal brain dysfunction (MBD) was a direct historical and ontological precursor to the label of “attention deficit disorder” which was subsequently combined with “hyperkinetic disorder” (‘hyperactivity’) to create the current label of “attention deficit hyperactivity disorder”. This historical and ontological connection is hinted at by Dr Green in his section on “the cause” (of ADHD): 372

“For years it was presumed, but not proven, that ADHD is caused by a minor difference in brain function. Now this can be shown by imaging techniques such as PET, SPECT, and volumetric and functional MRI. In ADHD, scans using these techniques show a slight difference in function and anatomy in the behaviour-inhibiting areas of the brain (the frontal lobes and their close connections). The mechanism of this under-function seems in part to be caused by an imbalance of the neurotransmitters noradrenaline and dopamine. The effect of stimulant medications, which are used to treat ADHD, is to increase production of these natural chemicals.” (p.119)

It appears that what was “so called minimal brain dysfunction” has, with a simple name change, been given a mantle of certainty – according to Dr Green, ADHD is “caused by a subtle difference in the fine-tuning of the normal brain”. With remarkable similarity to the hypothesised aetiology of schizophrenia (see page 15), ADHD is said to be caused by “chemical (neurotransmitter) imbalance” which is largely inherited (genetically, rather than socially) resulting in abnormalities in brain function. Rather than looking at the whole brain (or the whole child) Dr Green claims that “at present, most research interest is focused on the frontal lobe-basal ganglia circuit”. Ironically, he describes one of the characteristics of “inattention” as “gets over-focused on one part and misses the bigger picture”.

What is the bigger picture regarding attention, attention deficit, and attention deficit disorder? What causes more difficulty in concentrating – television (and other distractions), anxiety or genetic factors? Are stimulant drugs safe, effective “medications” or are they dangerous, addictive substances that cause chronic states of illhealth? Dr Green says, regarding ADHD (as he calls it), that “two things are certain” – but are they?:

“Until relatively recent times, professionals blamed the parents’ attachment or relationships for causing ADHD behaviours. Others said that ADHD was due to additives in food. Now we know that neither of these is the cause, although the standard of parenting and some food 373

substances may influence already existing ADHD. Two things are certain: firstly ADHD is strongly hereditary and, secondly, it is a biological condition.” (p.118)

If one examines the claims of Dr Green and others regarding the history of ADHD, certain inaccuracies and illogicalities soon become apparent. It also becomes evident that rather than presenting the evidence regarding drug treatment (the focus of the article) in a balanced way, Dr Green is intent on dispelling opposition to drug treatment in the guise of dispelling myths. He also tries hard to dispel opposition to the labelling of children and the dubious practice of experimenting with dangerous drugs on children:

“Diagnosis sometimes remains a matter of trial and error. At the present time it is seen as ‘politically incorrect’ to suggest that the diagnosis might be made by a trial of stimulant medication. This is despite unequivocal evidence showing that stimulants usually bring a major turnaround in ADHD to a degree that is not found in other conditions or with placebo. I believe that a robust response to any treatment usually suggests that we are on the right track, but this view would not be generally accepted for ADHD in 1998.” (p.122)

The idea of “trial and error” diagnoses made depending on the response to stimulating drugs is not only medically and ethically questionable, it is an abuse of children and of their trusting parents, especially when presented with “scientific” claims such as:

“Because of our modern understanding of the brain chemical imbalance in ADHD, most children who present with a major problem will be given a trial of stimulant medication as an essential part of their treatment. This helps the child to focus and self-monitor, and allows the teacher and behaviourist to reach them. Once we reach, then we can teach.” (p.122)

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The final slogan is slick, glib, and very misleading. Reaching and teaching are undoubtedly good things if what is taught is true and facilitates improved health. If what is taught makes a child or adult ill, it is obviously not good. If parents are taught that their angry, sad or fearful child is suffering from a “chemical imbalance” and that the best treatment is addictive drugs, the harm that can result is plainly evident. Dr Green advises that “if ADHD behaviours are present to a major degree, the child should be referred to either a paediatrician or a child psychiatrist”, admitting also that “in Australia and New Zealand the prescription of stimulant medications for ADHD is almost entirely restricted to paediatricians, neurologists and psychiatrists. He himself is a paediatrician (a children’s medical specialist). Although when he refers to “teachers” Dr Green is talking about classroom teachers, the word ‘doctor’ is taken from the Greek word for teacher. Teaching is, in fact, an essential function of any physician, and it is obvious that this teaching, to be therapeutic, must lead towards health, rather than disease. As a scientific teacher, a good physican must obviously teach what is factually correct – what is true. Good teaching cannot be centred on propaganda, and it cannot be biased – it should encourage students (those who are taught) to think for themselves and to critically evaluate what is taught (including what is taught by the teacher). Propaganda, on the other hand, leads to the uncritical acceptance of dogmas and doctrines that do not stand up to objective evaluation – and is a root cause of mass-delusions.

In 1995, when I first started looking in detail at the medical and scientific literature on the brain and began comparing this with psychiatric doctrine, attention and concentration was one of the mental activities I was particularly interested in. I was consciously seeking the “bigger picture” and was concerned that stimulant drugs were already being seriously over-prescribed by medical specialists in Australia (the situation has since worsened). One thing I had noticed is that while many doctors were concerned, even in the 1980s, that television was interfering with children’s concentration (and behaviour) this was not being mentioned in medical texts on the brain or in psychiatric texts about the causes of human behavioural problems. New labels were constantly being created but the many identifiable environmental causes of psychological disturbance were being systematically ignored. In the case of “attention deficit disorder” I always had maintained a moderate degree of scepticism. It is presumably because of widespead cynicism (within the medical profession) towards the labels of ‘ADD’ and ‘ADHD’ that Christopher Green wrote, with a hint of sarcasm: 375

“It is of great concern to those who philosophise about the existence of ADHD that there is no clear-cut line between those who have a normally active, impulsive and inattentive temperament and those who suffer the disorder. If we use the American Psychiatric Association’s criteria for the diagnosis of ADHD (DSM-IV), six out of a list of nine difficult behaviours must be present. But life is not as simple as this. If one child has six of the behaviours, yet has a saint for a mother and the best teacher in the country, we may not consider diagnosing or treating. If another child has only five of the listed behaviours, but home and school are hanging by a thread, this child may be diagnosed and treated for ADHD…A brain chemical imbalance cannot be viewed in black and white terms – it is greatly influenced by other factors, especially the living environment.” (p.120)

The literal claim above is that “a brain chemical imbalance” is influenced by the living environment. Is this true? Probably. Is attention deficit hyperactivity disorder caused by a chemical imbalance? To examine this question let us look at the two chemicals Dr Green claims are implicated in the aetiology of ADHD and why he believes they are at the root of the “disorder”. These chemicals are the catecholamines dopamine and noradrenaline. Dopamine is, as earlier described, also argued to be “imbalanced” in schizophrenia, and “schizophrenia” is said, like ADHD, to be a largely hereditary “biological illness” (with accompanying brain dysfunction). Both ADHD and schizophrenia are said to involve dysfunction in the frontal lobes, and it has been claimed that modern dynamic brain scans have demonstrated the long-anticipated “subtle abnormalities in brain function”. The evidence of “genetic factors” in the inheritance of both conditions is based on “family clustering” and twin studies – and in both cases the possibilities of diagnostic prejudice, learned influences and telepathic factors are routinely ignored. While the latter (telepathic influences) may be more speculative, diagnostic prejudice and learned factors cannot be reasonably discounted when researching these conditions.

Leaving aside environmental factors for the moment, any logical evaluation of the “chemical imbalance theory” is bound to reveal a series of circular arguments and simplistic suppositions. Dr 376

Green claims explicitly that ADHD is caused by chemical imbalances which are “normalised” by stimulant drugs:

“The stimulant drugs used in ADHD act by normalising the imbalance in the brain’s natural neurotransmitter chemicals; that is, they increase noradrenaline and dopamine.”

This argument is remarkably similar to that which claims proof of dopamine imbalance as the cause of schizophrenia in the supposed ‘efficacy’ of dopamine-receptor blocking drugs in the treatment of “schizophrenics”. The theory of “chemical imbalance” as a (or the) cause of the “illness” follows many years of treatment with drugs that affect nerve cells (neurones) and brain function by increasing or decreasing the activity of neurotransmitters. These particular chemicals are implicated because psychoactive drugs are known to affect them rather than drugs being designed because chemical imbalances are known to cause the diseases that are to be treated. The simplistic model being put forward by Dr Green is that abnormally low levels of dopamine and noradrenaline must be the “cause” of ADHD because amphetamines are known to increase the levels of these chemicals in the brain, just as the simplistic “biological psychiatry” model supposes that because “antipsychotics” block dopamine receptors, excessive dopaminergic activity must be the cause of “schizophrenia”. As Edward Shorter pertinently observed in A History of Psychiatry, the one-neurotransmitter-one-disease hypothesis presents a convenient marketing strategy for drug companies – but they are, frankly, bad science. Their practical application results in bad medicine and their dissemination to the public is bad education (miseducation).

The “chemical aetiology” theory of ADHD is an especially glaring example of reductionism taken to ludicrous extremes. It should be clear to anyone who reads the DSM IV criteria for diagnosis of AD/HD that these are primarily social, rather than “biological”. The condition is diagnosed in children who disobey the rules of adults. This is deemed to be “unacceptable behaviour” – behaviour such as talking, climbing and running at “inappropriate times”, “getting up frequently from the table at mealtimes or while watching television”, not finishing homework and so on. Dr Green also claims, in line with 377

American psychiatric dogma, that 40-60% of children with ADHD also have “oppositional defiant disorder” and upto 20% of children with ADHD also suffer from “conduct disorder”, other cruel labels for disobedient (or ‘difficult’) children (see page 79). Yet his own account of the condition makes the “chemical imbalance theory” untenable as a meaningful aetiological explanation.

The widespread claim that the condition is “strongly hereditary” (see Levy, et al, 1997; Macdonald, 1997) is contradicted by the fact that in the 1950s, 60s, 70s and 80s very few children were diagnosed as having “hyperactivity” or “minimal brain dysfunction” compared with the number who are now being diagnosed with the composite label of ADHD. As for the claim by Dr Green that “stimulant medication was first used for ADHD in 1937” it is a matter of historical fact that the children who were being treated with amphetamines in 1937 (and Ritalin in 1958) had not been diagnosed with ADHD or ADD (‘attention deficit disorder’). The label they were given was “hyperactivity”, “hyperkinetic disorder” or “minimal brain dysfunction” – and the symptom constructs for these labels, though authoritarian, were not as harsh as those of the modern labels of ADHD, ‘conduct disorder’ and ‘oppositional defiant disorder’ (see page 80). In terms of prevalence, hyperactivity was said, when I was at university in the 1980s, to affect about 1 in 200 children (0.5%). Christopher Green claims that, “ADHD affects at least 2% of the school-age population, and some quote figures as high as 5%”. The bigger the market, the bigger the profits from treatment, and this is one market that has grown alarmingly in the past 5 years.

While “biological treatments” are said to also include electroconvulsive treatment (ECT) and brain mutilation (‘psychosurgery’), the main focus of ‘biological psychiatrists’ is on neurotransmitters and drugs that affect them. Of these neurotransmitters, dopamine, noradrenaline, acetyl choline and serotonin have been those most intensely studied (together with the neurohormone melatonin) by psychiatrists, for the simple reason that drugs that have been used in ‘biological psychiatry’ for many decades are known to affect these chemicals. On this matter it is important to note that theories about the causation of schizophrenia, ADHD, depression and dementia centred on specific neurotransmitter abnormalities follow the “success” of drugs which affect neurotransmitters in “improving the 378

symptoms and signs” of schizophrenia, depression and dementia. These theories also provide a convenient marketing strategy for drugs, as Edward Shorter admits:

“Until the 1980s, research in the field tended to be organized along the lines of one- neurotransmitter, one-disease: the catecholamines, meaning such natural brain chemicals as noradrenalin, were assigned to mood disorders. This was called the ‘amine hypothesis of depression.’ It later included serotonin. Such neurotransmitters as dopamine were linked to psychosis; and acetylcholine was paired with dementia.

“The one-neurotansmitter-one-disease hypothesis seemed so reasonable (and was, moreover, a perfect marketing concept for the drug companies). Yet correlation does not necessarily mean causation. The one-one paradigm tended to collapse in the 1980s. Highly effective antipsychotic drugs such as clozapine were discovered to have little impact on dopamine metabolism but instead affected serotonin. (Although clozapine was discovered in the mid- 1970s, only after 1988 did the implications of it for the treatment of schizophrenia begin to sink in.) As more and more neurotransmitters were identified – over 40 by the mid-1990s – it became apparent that dopamine and serotonin were only two of many transmitters involved in these complex psychiatric disorders and probably did not play a master role. Yet over the years, the one-transmitter-one-disease hypothesis proved highly fruitful in terms of stimulating research on basic brain mechanisms. Somehow these drugs did work, and their very efficacy opened up the domain of the neurosciences in a way that previous hypotheses had not.” (p.267)

It actually misled the medical profession into believing that human behaviour is “explained” by chemical activity, and paved the way for an unprecedented explosion of drug prescriptions to “correct the chemical imbalances” that the “amine hypotheses” insisted were at the root of depression and schizophrenia (and later ADHD). Furthermore, the “collapse of the one-one paradigm” has not been as complete at Professor Shorter believes. When it supports a multi-billion dollar research industry and a multi-billion dollar psychoactive drug industry, simplistic theories, regardless of how powerfully refuted, are not readily abandoned by those who have built empires on them. 379

The 1997 Annual Report of the Mental Health Research Institute in Melbourne explains the core assumptions of the Molecular Schizophrenia Division:

“Dopamine is a chemical within the brain which is thought to be important in the pathology of schizophrenia. The major evidence for this is that drugs which behave like dopamine in the brain can cause a psychosis reminiscent of schizophrenia in non-schizophrenic individuals. In addition, the antipsychotic drugs that are used to treat schizophrenia reduce the activity of dopamine in the human brain. Together, these observations suggest that over-activity of the dopamine neuronal pathways are important in the pathology of the illness. (p.18)

The report also refers to the connection between “serotonin neurobiology and schizophrenia” without drawing attention to the doubt the supposed efficacy of clozapine (the ‘antipsychotic’ that affects serotonin rather than dopamine activity) lends to the “dopamine hypothesis” (above):

“As is the case for dopamine-like drugs, drugs which behave like serotonin can cause psychosis in individuals who are not schizophrenic. Conversely, newer antipsychotic drugs decrease the activity of serotonin in the human brain [a reference to clozapine]. As a result of these two findings serotonin is also thought to be important in the pathology of schizophrenia.” (p.19)

It can be seen that the main mental health research institution in Victoria is keeping the amine hypothesis alive, replacing the “one-one” hypothesis with a multiple (or dual) amine hypothesis. This can be simply explained as: “high dopamine and high serotonin cause schizophrenia”, “low serotonin and noradrenaline cause depression”. All that has really been done is the addition of serotonin, the neurotransmitter affected by Prozac and other new SSRI ‘antidepressant drugs’ (and clozapine) to the old (and discredited) dopamine and noradrenaline amine hypotheses. This obviously provides a convenient “explanation of mechanism of action” when marketing these drugs to doctors and the public (many ‘popular psychiatry’ books have promoted SSRI antidepressants, in particular, in recent years, such as Ronald Fieve’s Prozac, and Michael Norden’s Beyond Prozac, both Harper Collins 380

publications). Many outrageous claims are routinely made about these drugs ‘miraculous’ efficacy – the overused (and militaristic) ‘magic bullet’ claim has been reinvented.

Nevertheless, the observed ‘efficacy’ of these drugs must be explained by any competing hypothesis, together with an explanation of why drugs that mimic or increase dopamine activity (such as amphetamines) can produce the symptoms of ‘schizophrenia’. In the following pages an integrative neurobiological model will be presented that brings together known neuroanatomical pathways and connections with recent (and older) neurobiochemical dicoveries, while attempting to bring the brain’s chemicals into perspective – in terms of other aspects of physiology and psychology. The primary objective of this model is to provide a framework for the development and promotion of mental and physical health.

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THE AMINE HYPOTHESIS IN A NEW LIGHT

All psychoactive drugs affect brain chemistry – this is obviously what they are supposed to do. They specifically affect neurotransmitters, chemical messengers in the brain which enable communication between neurones (brain cells) at synapses (junctions between neuronal processes known as axons and dendrons). There are several known neurotransmitters, and much is known about their biochemistry and activity on a cellular level, especially the catecholamines – dopamine, noradrenaline and adrenaline. We know that neurones (and other cells) have specific protein receptors on their cell membranes, and that by binding with these receptors, neurotransmitters affect the activity of nerve cells – and ultimately of the whole brain. While it is nonsense to claim that humans are just a mass of chemicals, or that complex behavior can be explained just on the basis of chemicals (or chemical imbalances), it cannot be denied that chemicals, both those produced naturally by the body and those introduced into it, can profoundly affect mental and physical health.

If it is accepted that thought is produced by the brain (and it may not be), neurotransmitters are necessary for any thought, because brains cannot work without neurotransmitters crossing synapses and binding to receptors. It is important to remember (and often forgotton) that thought can also cause chemical changes – including changes in the activity of neurotransmitters. This includes increases and decreases in the amount of individual neurotransmitters secreted by neurones and changes in the relative amounts of (and thus balance between) different neurotransmitters. Changes in mental state and various physical activities also affect the secretion of other chemicals in the brain (such as neurohormones) which in turn regulate the entire biochemistry of the body. Chemical activity is, though, only a part of the total physiology of the body, and cannot be understood in isolation from anatomy (structure) and other physical processes such as electrical activity and movement. Despite the fact that biochemistry is a “separate discipline” from “anatomy” and “physiology”, it is impossible to understand biochemistry (the study of the chemicals of life) without also knowing where the chemicals are (necessitating knowledge of anatomy), and what they do (necessitating knowledge of physiology). 382

‘Biogenic amines’ is a term that is used to describe a related range of small biological molecules that are synthesised from amino acids in the brain and elsewhere in the body. They are essential for all vertebrate (and most invertebrate) life, and are necessary for thought, as we know it. This assumes that thought results from and requires activity in the brain, and assumes also that brains cannot function without neurotransmitters to transmit neuronal impulses across synapses. Are these reasonable assumptions? While it is a central neurosciences assumption that thought cannot exist without a brain (and I am inclined to agree) this precludes the existence of disembodied ‘spirits’ that think and behave like people with brains. Almost every religion (perhaps every religion) teaches, however, that disembodied spirits do exist – whether these are called ghosts, souls, spirits, angels or demons. “God”, himself, herself, or itself is also frequently conceived of as a disembodied spirit that “thinks”, “plans”, “creates” and “judges”. Such beliefs cannot easily be reconciled with the idea that thought inevitably results from brain activity, and the following discussion of biogenic amines may make little sense to people holding such views (I hope, however, to stop people with such beliefs being diagnosed as ‘schizophrenic’ or otherwise mentally ill).

Several (but not all) of the known neurotransmitters in the brain are amines. These include the catecholamines dopamine, noradrenaline and adrenaline, which are manufactured from the amino acid tyrosine, and the ‘indole amine’ serotonin, which is synthesised from the dietary amino acid tryptophan. Melatonin, the neurohormone that has been associated with ‘seasonal affective disorder’ and which is being marketed as a treatment for this ‘new’ psychiatric label and for ‘jet lag’ (and other conditions) is synthesised in the pineal organ from serotonin, and is also an ‘indole amine’ (Wurtman, 1980, p.1813). Serotonin, although concentrated in the pineal, is also known to act as a neurotransmitter in other parts of the brain, and is also produced elsewhere in the body, such as the intestines (Harper, 1965, p. 298). Dopamine and noradrenaline (which is synthesised from dopamine) are also manufactured in the brain and elsewhere in the nervous system, while adrenaline is mainly secreted by the adrenal glands atop the kidneys (under the stimulatory influence of the sympathetic nervous system). The secretion of adrenaline in response to stress is one obvious example of an important fact that is ignored by those putting forward ‘amine hypotheses’: changes in amine activity 383

may affect thought (and thus behaviour), but change in thought and behaviour can also affect amine levels.

The following diagram presents an overview and integration of established catecholamine and indole amine biochemistry, including the anatomical and physiological connections between the natural synthetic pathways for catecholamines and indole amines.

Figure 3. Integration of catecholamine and indole amine hypotheses:

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Figure 3 is a flow chart showing the known pathways for the synthesis of catecholamines (on the left side) and the indole amines on the right (in the ‘pineal organ’ box). The catecholamines (dopamine, noradrenaline and adrenaline) are synthesised from the amino acid tyrosine. Tyrosine is either ingested in the diet or manufactured in the body from the essential amino acid phenyl alanine (which is obtained from food). The indole amines (serotonin and melatonin) are manufactured from the dietary amino acid tryptophan, the only amino acid containing an indole ring (which is retained in serotonin and melatonin molecules). Serotonin is manufactured in several areas of the body (notably the gut, where it is synthesised in the intestinal wall), but most of the serotonin in the brain is manufactured in the raphe nuclei of the brainstem and in the pineal organ, where it is concentrated. It is known that serotonin in more highly concentrated in the pineal than in any other part of the brain (Reiter, 1983, 1984; Relkin, 1983; Arendt, 1995) – and it has been known, since the 1960s, that in the pineal serotonin is converted to the neurohormone melatonin. Melatonin synthesis and release into the blood-stream occurs only at night and during the hours of darkness. It has been reliably demonstrated that light entering the eyes suppresses melatonin synthesis within minutes, and it is known that the pineal is neurally (via nerves) connected to the visual system in humans and other mammals (Isselbacher, 1980; Relkin, 1983; Reiter, 1984; Arendt, 1995).

These facts, though not widely known, are not in dispute, although many claims about the pineal and its function are. Before we look at these claims and their implication for medicine and health, the better understood activities of the catecholamines will be reviewed.

What Dr James Parkinson first described as “the shaking palsy” in 1817 is now known as “Parkinson’s disease”. Characterised by tremor, stiffness and difficulty in initiating movement, this common neurological disease is now believed to be primarily caused by degeneration of dopamine-producing neurones in a central area of the brain known as the “basal ganglia” (fig 6). As in the case of the “limbic system” the term “basal ganglia” is currently used to include somewhat different parts of the brain to what was initially conceived by those who coined the term. There is no dispute, however, that the structures included as part of the “basal ganglia” (then and now) are involved in voluntary 385

movement and that the neurotransmitter dopamine is active within the caudate nucleus, putamen, globus pallidus and other ganglia in the mid-brain. Most of this dopamine is synthesised in pigmented neurones in the “substantia nigra”, which is now regarded as part of the “basal ganglia” (Kandel, 1995). There exists an area of substantia nigra on either side of the brain, and the neurones are pigmented with granules of melanin (the same pigment that is synthesised by melanocytes in the skin and the retina and iris of the eye). Dopamine, which was discovered to function as a neurotransmitter in mammals by the Swedish pharmacologist Arvid Carlsson in 1957, is also active in other parts of the brain, including the limbic system and frontal lobes (Kandel, 1995). The same molecule has non-neurological physiological roles, influencing blood pressure (and dynamics) and acting as a precursor to the other catecholamines, noradrenaline and adrenaline (Shand, Oates, 1980, p. 392). Confusingly, the same chemical called “noradrenaline” in Britain and the British Commonwealth is called “norepinephrine” in the USA; correspondingly “adrenaline” is known as “epinephrine” in the USA. In this text I will continue to use the terms “adrenaline” and “noradrenaline”, but these are exactly the same substances as “epinephrine” and “norepinephrine”.

“Adrenaline” was so named because it is mainly produced by the medulla (core) of the adrenal glands, small endocrine glands located immediately above the kidneys. The adrenal medulla, which is regarded as part of the sympathetic nervous system, also secretes noradrenaline and dopamine into the blood- stream, synthesising these from the amino acids tyrosine and phenyl alanine (Harper, 1965, p.295). Tyrosine, as mentioned, is an amino acid that can be manufactured in the body (from the essential amino acid phenyl alanine) or absorbed directly from digested food in the digestive tract. The metabolic process whereby dopamine, noradrenaline and adrenaline molecules are synthesised is occurring constantly, in both the central nervous system (brain and spinal cord) and the autonomic nervous system (the sympathetic branch of it). Molecules of catecholamine may exist for only a few minutes before they are broken down by MAO (the enzyme mono-amine oxidase). In the synapses (junctions between neurones) the catecholamines, as in the case of other monoamine neurotransmitters such as serotonin (but unlike acetyl choline), are “recycled” – they are reabsorbed by the nerve terminals and subsequently re-used in the same synapse. The trillions of molecules of catecholamine active in the body at any one time and their creation and destruction is a constant metabolic process. Some of the catecholamine molecules are circulating in the blood-stream and thus able to have effects 386

on non-neuronal cells, and others are stored within vesicles in synapses, ready for release when an electrical impulse reaches the nerve ending.

In the brain, most noradrenaline is thought to be manufactured (from dopamine) in an area of the brainstem known as the locus ceruleus, and the catecholamine is concentrated in the hypothalamus. Most of the catecholamine molecules in the brain are dopamine or noradrenaline, rather than adrenaline, whose role as a neurotransmitter in the central nervous system is a more recent (and less certain) discovery. The actions of noradrenaline in the brain and the sympathetic nervous system have been known about, on the other hand, for several decades and have been extensively researched in humans and other animals. Much of this research has involved blocking receptors for different neurotransmitters with different drugs or stimulating their release (again, using different drugs).

Neurotransmitters and other biochemical messengers act by binding with protein receptors on the cell walls (‘cell membranes’, or ‘plasma membranes’) of “effector cells”. The term ‘effector cell’ is given to any cell that responds to a particular neurotransmitter. Over the past forty years it has become evident that the different responses of different effector cells depend, largely, on the presence of different types of receptors on their cell walls. In the case of cells that react to noradrenaline, they may have alpha or beta receptors studded on their surface, and the same substance (noradrenaline) has very different effects on cells with alpha receptors versus ones with beta receptors. Several different types of dopamine receptors, known as d1, d2, and d3 receptors have also been identified. Adding to the complexity of the neurotransmitter system and cellular responses, each cell has several different receptors on its surface, making it responsive not just to neurotransmitters but to endocrine hormones, neurohormones, cytokines and other chemical messengers that arrive at the cell via the blood stream and extracellular fluid rather than from nerve synapses.

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Figure 4: The main stimulatory neurotransmitters:

The concentration of dopamine and noradrenaline varies in different parts of the brain, as does the concentration of serotonin. From this (and for other reasons) it has been inferred that some areas of the brain contain dopaminergic neurones (those utilising dopamine as a neurotransmitter) and some contain adrenergic (noradrenaline-sensitive) neurones. Other neurones in the brain utilise acetyl choline (ACh) as a transmitter – including, it is thought, those of the afferent (incoming) nerve fibres of the visual and auditory systems and those in parts of the limbic system such as the hippocampus. Most of the synapses in the limbic system are thought to be dopaminergic (using dopamine as a transmitter) as are most of those in the basal ganglia. Neurones in (outer) cortical areas of the brain utilise several different transmitters in their trillions of synapses – including dopamine, noradrenaline, acetyl choline, serotonin and probably adrenaline. Linking these areas of the brain is a network of neurones that are 388

also mainly adrenergic (utilising noradrenaline in its synapses), the reticular activating system (RAS), which is known to be involved in regulating one’s state of consciousness, including attention, concentration, and sleep (Adams, 1980, p.127).

The fact that the RAS neurons are involved in mammalian level of consciousness has been known for many decades. Anaesthetic drugs that block activity of the RAS cause unconsciousness – and are routinely used during surgical operations (and electroconvulsive therapy). Many experiments have been done on cats, in particular, where the spinal cord and brainstem have been severed in an effort to localise the activity of the RAS.

The 1980 edition of the reference text Harrison’s Principles of Internal Medicine refers to such experiments in a section titled “Morbid Anatomy and Physiology of Coma” in the textbook’s chapter on “Coma and related disturbances of consciousness”:

“The essence of more recent neurophysiologic studies…is that a systematic series of destructive lesions of spinal cord, medulla, pons, and cerebellum has no effect on the state of consciousness until the level of midbrain and diencephalon (thalamus) is reached. High brainstem transections invariably induce states of prolonged unresponsiveness, whereas stimulation of the upper brainstem reticular formation causes a drowsy or sleeping animal to become suddenly alert and its EEG to change correspondingly. As anaesthetic agents abolish consciousness, they are found to suppress the activity of the upper reticular activating system, without interfering, at least at certain levels, with the transmission of specific sensory impulses en route to the parietal lobe cortex.” (p.116)

The textbook also indicates that extensive studies have been done on serotonin, the RAS and sleep (p.126), and provides a hypothesis regarding the physiology of sleep involving serotonin acting on the 389

brainstem RAS. No explanation is provided, however, for the fact that sleep is refreshing – or for why sleep is helpful during recovery from many illnesses.

The fact that dopamine receptors are found in large number in areas of the brain involved in movement (the basal ganglia, especially) and emotions (various ‘limbic’ structures) explains both the ‘efficacy’ and the toxicity of ‘anti-psychotic’ drugs. These drugs block dopamine receptors, thus blocking movement and emotional expression and subsequently cause irreversible damage to the receptors, and the cells on which they are located. This explains the iatrogenic disorder named “tardive dyskinesia” and the chronic brain damage that results from long-term exposure to these drugs (such as increased production of receptors to compensate for damaged ones). The degeneration of neurones that have been subjected to chronic receptor damage explains the “enlarged ventricles” and loss of brain size that has been reported in “schizophrenics” on autopsy. Contrary to some claims, no consistent evidence has emerged of differences in the brains of people diagnosed with schizophrenia before treatment compared with the general population – and signficant differences have been noted after long-term and even short-term treatment with dopamine-blocking drugs. The most consistent of such findings (although still subject to dispute) have been increased numbers of dopamine receptors in limbic system brain cells, and smaller hippocampal gyri in ‘schizophrenics’ (on scans and at autopsy).

All the older ‘antipsychotics’ block dopamine receptors, and all the people whose brains have shown “abnormalities” in the number of these receptors, and in the size of their ventricles (the fluid-filled chambers in the core of the brain) have been treated for months or years with dopamine-blocking drugs. The specific areas of the brain that are said to be “smaller in schizophrenics” (such as the hippocampus and frontal lobes) happen to contain large numbers of dopaminergic neurones. This proves not that schizophrenia is caused by abnormalities in the brain, but that the standard treatments for schizophrenia causes brain damage.

The commonest ‘side-effect’ of dopamine-blockers is ‘Parkinsonism’ and it is accepted that this iatrogenic condition is caused by dopamine blockade in the basal ganglia. Idiopathic Parkinson’s disease, which mainly affects older people, is known to be caused by degeneration and loss of neurones in the basal ganglia and substantia nigra. Drug-induced Parkinsonism, traumatic Parkinson’s disease 390

(such as boxers develop) and idiopathic Parkinson’s disease share many features, such as uncontrollable tremor, muscular weakness and stiffness, difficulty in initiating (and stopping) voluntary movement and a tendency to psychic depression (‘psychic’ meaning ‘mental’, or of the mind, rather than of the body).

Figure 5: The Basal Ganglia:

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Figure 6: location of the basal ganglia

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Figures 5 and 6 show the shape and position of the nuclei (ganglia) that are collectively known as the “basal ganglia”. The terms nucleus (plural nuclei) and ganglion (plural ganglia) are used, in neurology, to refer to large collections of nerve cell bodies. The “grey matter” of the brain and spinal cord is composed mainly of nerve cell bodies (and supportive glial cells) while the “white matter” is composed of tracts of nerve fibres rather than cell bodies. The nerve fibres in white matter and in peripheral nerves are mainly composed of ‘axons’, the long processes that carry outgoing signals from the cell body (which contains the nucleus of the neurone). Thus the term ‘nucleus’ is used to refer to both collections of millions of neurones and the organelle which contains the DNA (chromatin) in the body of individual nerve cells (neurones). The structure of a “typical neurone” is shown in figure 7. It demonstrates the nucleus, incoming dendrons and outgoing axon. Axons and dendrons are extensions of the neuronal cell body, and the plasma membrane which encapsulates the cell body is continuous with the walls of the axons and dendrons. Thus the cytoplasm (the fluid that fills the cell) in the cell body is continuous with that within the axons and dendrons. This allows neurotransmitters to diffuse from the body of the cell to the nerve terminals at the ends of the axons and dendrons, where they are stored in tiny vesicles, ready for release.

Fig. 7: Neurone showing nucleus, axon and dendrons

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It has been estimated that the grey matter of the human brain contains about 100,000,000,000 (one hundred billion) neurones (nerve cells). These are connected with each other in an intrincate network – a neural network containing, it is thought, about 500 trillion synapses. This neural network produces electrical impulses which travel along the nerve fibres in a constant orchestra of activity that begins when the first nerve cells develop in the embryo and cease only when the brain is dead. Old connections are being lost and new connections being formed throughout life. The network of neurones in the brain is directly connected with the network of nerves throughout the body. Efferent (outgoing) peripheral nerves are composed of long axons which are themselves cytoplasmic extensions of cells located in ganglia within the brain and other parts of the central nervous system. Afferent (incoming) nerves are composed of the axons of neurones located in various parts of the body (such as the skin, eyes and other sense organs, but also in muscles and internal organs). These axons conduct electrical signals to the central nervous system – the brain and spinal cord. The spinal cord is itself a direct extension of the brain and the ‘white matter’ of the spinal cord is composed of axons (and their myelin sheaths) of nerve cells that are mostly located in the brain (which contains most of the neurones in the body).

The electrical circuits in the brain have been partially mapped and the amount of electricity generated by the brain can be measured. The voltage of electrical currents in the brain is very small in comparison with that in household wiring, and the electrical impulses (action potentials) that travel along individual nerve fibres have an amplitude of about 100 millivolts (100 thousanths of a volt). Axons, which range in diameter from 0.2 to 20 micrometres (microns, or millions of a metre), conduct these electrical impulses at the speed of between 1 and 100 metres per second. The term ‘action potential’ is used to describe an individual electrical impulse in a single axon or dendron. Some cells can generate (and some axons and dendrons can carry) upto 1000 action potentials every second. This is going on all the time, from early embryonic life until death of the brain and nervous system – neurones are generating action potentials, and these are being carried around the brain through the complex neural network that begins, in the case of humans, as a “neural plate” in 18-day-old embryos.

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The development of the human brain is very similar to the development of other mammalian brains, and the brains of other terrestrial vertebrates, such as birds and lizards. These creatures also have two cerebral hemispheres, including frontal, parietal, temporal and occipital lobes. All contain a limbic system and all have basal ganglia. All have a brain stem and cerebellum, a hypothalamus and pituitary gland. Almost all vertebrates contain pineal organs (exceptions, apparently, being the South American sloth and some species of crocodile). All vertebrates have sense organs containing neurones that transmit action potentials to their brains, and areas of motor cortex that generate signals which allow for voluntary movement – which, in all vertebrates, is executed by the contraction and relaxation of muscles. Every vertebrate has an autonomic nervous system which can be divided into sympathetic and parasympathetic branches, an endocrine system, immune system, respiratory system, cardiovascular system, digestive system and reproductive system. In all, these systems are directly and indirectly influenced by activity in their brains. It is because of these commonalities that birds, other mammals and even frogs, have been extensively experimented upon in an effort to understand human biology. However, the human brain is different from that of other animals, and this is reflected in obvious differences between human behaviour and that of other animals.

One obvious way to study human and animal emotions is by careful observation of facial expressions. As social primates, humans have complex facial musculature and expressive faces. We share many gestures and expressions with other apes, such as smiling, laughing, frowning and grimacing. Through cross-cultural studies, certain emotions have been associated with distinctive facial expressions which are readily recognised by people of completely different cultural background. These include happiness, sadness, surprise, fear, anger and disgust. Other emotions such as jealousy and love are not so easily recognised by facial expressions, and it requires careful listening to what a person says to understand the complexities of what he or she feels. It does not require much thought, however, to deduce that if depression can be caused by social isolation and lack of love, love is likely to be a good antidote for depression.

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Studying commonalities between the behaviour of humans and that of other animals can be useful in identifying what might be “natural” or “instinctual” behaviour in all mammals (such as communication, curiosity and play). A survival instinct is another obvious candidate – all mammals appear to have an individual drive to survive. While the examples of “lemmings” and “beached whales” might be suggested as situations where animals kill themselves, there are other, more credible, explanations for these puzzling zoological phenomena. Chimpanzees, gorillas and other “higher primates” are not known to attempt suicide, even when subjected to terrible cruelty – although they do exhibit fear, anger and resentment. Dogs, the subjects of some of the most callous experiments of all, also show these same emotions when ill-treated, but are not known to deliberately kill themselves, and neither are cats. These easily observable facts suggest that some attribute of the human condition (or mind) makes us more likely to kill ourselves – and to kill others of the same species – and to kill creatures that are not directly threatening us or our families or needed for food, simply because we didn’t like them or thought they could become a threat in the future. Other animals do not, as far as we can tell (and it has been looked for), consciously wage wars – they do not organise among themselves to torture, poison or starve other creatures, exploit them or addict them to drugs. These ideas are the products of the “advanced” human brain – the brain that was regarded (by humans) as being “superior” to those of “lower animals” or “beasts”.

I recently watched a television program on animals’ emotions in which the questions were asked as to whether animals “have emotions”, and whether they are “self-aware”. It was pointed out that no one who has considered the matter deeply could doubt that other mammals have emotions – and that this can easily be seen on their faces, but that, in the case of reptiles and birds, whose facial musculature is less complex, the emotions may not be as clearly displayed as in apes and other mammals. A close study of fish, amphibians, reptiles and birds suggests, however, that they do, indeed, have emotions – as would be expected from the structure of their brains and the similarities between their brains and our own. The structure of particular importance in this matter seems to be the limbic system and specifically a ganglion within the system known as the amygdala (see figures 5 and 6).

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The amygdala, which is located at the junction between the limbic system and the basal ganglia has been extensively studied by neurobiologists over the past 15 years and is thought to be the single most important part of the brain in terms of emotions – it has been thus termed the “emotional centre” of the brain. The role of the amygdala in mediating emotional reactions is evidenced by the fact that electrical probes inserted into the amygdala of chimpanzees, monkeys, cats, rats, mice and dogs produce emotional reactions when an electrical current is passed into them. The observed reactions include unpleasant ones such as fear and rage, but also seemingly “pleasurable reactions” (observed in both rats and cats). Changes in physiological and metabolic activity in the amygdala (evidenced by increased blood flow and glucose consumption on PET scans) have also been reported with emotional stimuli (in humans as well as other mammals). Similar emotional reactions are not produced by electrical probes inserted in other parts of the brain – in some, no obvious effects occur, in others, movement is stimulated (such as the motor cortex), and in yet others, different effects occur.

Electrocuting different parts of the brain has been a mainstay of neurobiology research over the past fifty years, as have surgical experiments on the brain. Both forms of study have provided information of dispassionate scientific value, but both have also caused unimaginable suffering – to both animals and humans. One thing we have gained from these studies is detailed knowledge of what happens to mammals when they are tortured, mutilated and terrorised. Unfortunately we have learned much more about how to cause these things than how to prevent them. We have also learned more about how to create disease than how to cure it.

Several medical conditions and drug effects help shed light on the effects of catecholamines generally, and dopamine in particular. The medical conditions in which dopamine activity has been hypothesised to play a role include Parkinson’s disease (first named ‘paralysis agitans’), Tourette’s syndrome, encephalitis lethargica (‘Sleepy sickness’, not to be confused with ‘sleeping sickness’) and ‘schizophrenia’. The drugs that are known to increase dopaminergic activity include amphetamines and L-dopa, and the known effects of the ergot alkaloid LSD (lysergic acid diethylamide) and MDMA (also called ‘Ecstasy’), which mainly increase serotonin activity, also have relevance to an 397

understanding of the relationship between biogenic amines and mental activity. The effects of the ‘old’ (but still widely prescribed) tricyclic antidepressants (which influence noradrenaline activity, and to a lesser degree that of serotonin and melatonin), and that of the mono-amine oxidase inhibitor (MAOI) antidepressants which block an enzyme (MAO) that catalyses the breakdown of amines provide more data to integrate into a more complete “amine hypothesis”.

No amine hypothesis can, however, be complete as far as an explanation of mental illness (or health) is concerned, for there is obviously much more to the functioning of the brain and of complexities of human thought than any “chemical theory” can hope to explain. This chapter’s theoretical exploration is, therefore fundamentally (and perhaps inappropriately) reductionist – as well as fundamentally mechanistic. It is, however, a necessary step to countering reductionist, mechanistic theories such as the various amine theories. I have also tried to bring some of the relevant history, politics and sociology into the picture.

The “limbic system” has long been denigrated as being part of the “reptilian” or “avian” (bird) brain – a primitive part of the vertebrate brain of lesser value and importance than the “higher” cortical areas. The forebrain, or ‘neocortex’, greatly enlarged in primate and especially human brains, was seen as the home of man’s unique intelligence. This is one factor that led to a worsening of the academic (and medical) dualism between (good) “intellect” and (bad) “emotion”. While efforts have been made to correct this dualism by the recently promoted concept of “emotional intelligence” (Goleman, 1995), the idea that emotions are generally “negative” or problematic persists in many areas of the neurosciences and even in society at large (thus, describing someone as ‘emotional’ is rarely meant as a compliment).

A major problem that has resulted from this academic disconnection between “emotions” and “intellect” is that the influence of what we see and hear on our emotions, attitudes and beliefs have been hardly explored by the medical profession or the hundreds of “brain research” institutes around 398

the world. The failure to recognise environmental factors and audio-visual experiences as having a profound effect on the mind, and on emotions especially, has also resulted in a parallel failure to understand the mind-body relationship – how the mind affects the body and how the body affects the mind.

The idea that emotions were, in the civilised man, controlled (and suppressed) was further developed in the work of Freud. The “father of psychoanalysis”, together with other male medical academics, developed a series of theories that generally looked down on “emotional behaviour” and that of women and children, who were seen as being more “emotional” than (well-controlled, civilised) men. Men who showed “excesses” of emotion, whether these were excesses of happiness, excitement, love, fear, anger, jealousy or disgust could be diagnosed, according to newly developed psychiatric criteria, with an increasing range of “mental illnesses”. “Overemotional” women and children were also eligible for diagnoses of “mental illness”. The names they could be called have increased dramatically over the past 100 years, and the problem keeps growing.

Hundreds of emotions have also been named (Goleman, 1995), and varied efforts have been made to classify them, and identify which are related (anger and jealousy, for example), which are degrees of the ‘same emotion’ (anger and rage, for instance) and which are “positive/negative” or “good/bad”. These are all scientifically valid approaches to studying emotions, with implications for philosophy and politics as well as for health. Is it good to love and bad to hate? Does love lead to greater health, or greater wisdom, or greater happiness? These are philosophical questions but they also relate directly to medical science and biology. Despite its acknowledged importance to human psychology and life, doctors rarely speak to their patients about love and psychiatric texts ignore this emotion (dramatically, in comparison with the ‘negative emotions’ of fear and anger). The reasons for this are rooted in the history of the medical profession, and its confusion between love and sex (for which Freud holds some responsibility).

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Love cannot easily be explained in terms of chemistry (although one can love chemistry). Love can develop, and love is also not just an emotion – it is an entity that defies description in psychological terms, at least the terms we currently have in the English language. The ancient Greeks did rather better at defining different types of “love” than the English, whose language I was trained to think in, speak in and write in. Learning to think and speak in different languages is also impossible to explain in terms of chemistry alone or even using an integrated model of brain function that considers chemical as well as electrical and other physiological processes. Some mental processes can be partially understood using such a model, but this is still a reductionist pursuit, and limited by its reductionism. It cannot, for example, explain how and why love grows – unless purely psychological (including psychodynamic) processes are included in the theory.

Without love humanity is lost. We need to love other people and we need to be loved in return. If parents do not love their children the chance of their children surviving to adulthood is very much reduced. People’s chances of developing unhappiness and “depression” later in life are undoubtedly larger if they are deprived of love in their childhood; in fact ‘depression’ can occur at any age if people are deprived of love. Nevertheless, it is equally true that there is plenty of love around, it is free, and if people who are depressed, at any age, find love they usually recover. In terms of interpersonal love, friendships between people are the very foundations of human society and culture – the primary drive for communication and the development of language. As a healing force within society, the love parents have for their children and the reciprocal love children have for their parents is healthy for the whole family and people who come under their influence, as is love between siblings, and those who regard other humans as their “brothers and sisters”. Love is more than an emotion – it is a sentiment, and an ‘inanimate force’. It is as an ‘inanimate force’ that love acts as a social catalyst, and a healer of social, racial and political divisions. Love of all humanity can serve such a purpose, however love of only a few can have the reverse effect. While love (the sense of agape and philos) is vital to human survival, and a powerful force for healing, the word is used more carelessly than, perhaps, any other word in the English language. It has also been misused to manipulate people of all ages, but especially the young.

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The powerful emotion/sentiment of love has been politically abused by many regimes over the centuries, but none so clearly as the German Nazi (‘National Socialist’) regime in the 1930s. In a ruthless program of selective breeding the favoured Aryan children were united, via a careful program of systematic ‘education’ in their love for Germany, the Fatherland, ‘mother nature’ and the Feuhrer, Adolf Hitler. Hitler was venerated as a god, and lauded as the saviour of the oppressed German people. And indeed they were – they were oppressed by the very regime that Hitler presided over. While being simultaneously cajoled and seduced into the Nazi vision, the favoured Aryan children were programmed into a hatred of Jews, Gypsies and other “foreigners”. They chanted slogans full of hatred, love and self-sacrifice as they were trained to become the commanders and the cannon-fodder of the future.

The documentary series Hitler’s Children, recently shown on the SBS television station in Australia graphically revealed how this systematic brainwashing and reprogramming was done, through the unique perspective of the children who were deceived by their teachers and the state that was entrusted to educate them into a fervent love of Hitler and everything he stood for. Now elderly men and women in their seventies “Hitler’s children” have long had to face the fact that they were seduced by a carefully constructed system of propaganda. They were ‘infected’ with a collective delusion and were manipulated into enthusiastically supporting acts of unprecedented cruelty and callousness. Hilter, while orchestrating, together with senior German academics and generals, the extermination of millions, spoke frequently of his love of peace and the importance of love.

Although scientists have lagged behind philosophers, priests and poets in their pursuit of understanding love, this much venerated emotion has been studied, albeit in a rather strange way, by psychologists and physicians. The textbook we studied psychology from at the University of Queensland in the early 1980s, Psychology and Life, by Professor Philip Zimbardo of Stanford University in the USA, does mention love. Unlike many psychology textbooks, and most psychiatry textbooks, it even has a chapter devoted to love, titled “Liking, Loving and Sexual Relationships”. The index reference for “love” refers the reader to pages 667 to 677, including “theories of love” from page 670-673. The chapter 401

begins with a reference to how important love is, and why a reductionist approach (“the most intensive analysis of the individual elements involved”) is bound to fail as far as understanding the complexities and mysteries of love are concerned:

“Liking, loving, and sexual relationships forge the bonds of the human connection. This person-to-person connection expands the boundaries of our individual functioning by liberating the self from its solitary confinement.

“The ‘chemistry’ that occurs between two people in love cannot be fully understood from even the most intensive analysis of the individual elements involved. The relationship is the secret ingredient – the ‘we’ that transforms the ‘you’ and the ‘me’. Interaction is the special process – the mutual sharing that emerges from individuals giving and taking…The primary relationship between people is that which links a parent and a child. As part of an affectionate, stable family unit, the growing child develops a sense of personal integrity and security, while also learning to trust others, to share with them, and to enjoy their companionship. Self-respect and a sense of identity are developed in this crucible of positive regard and recognition by others. In less ideal social environments, we see other patterns forming: envy, jealousy, mistrust, exploitation, submission, and fear of authority.

“The child or adult who cannot reach out for the hand of another, or whose extended hand is not grasped in turn by another person, is cut adrift from the moorings of society. In many ways…the isolated individual is vulnerable to the pathologies of a self-centred existence: loneliness, depression, paranoia, suicide, and antisocial reactions.” (p.657)

The theory that social isolation causes depression makes more sense than the theory that depression is caused by “chemical imbalances”, yet medical and psychiatric textbooks do not mention social isolation as a cause (as opposed to a consequence) of depression. Actually, social isolation is often both a cause and a consequence of depression: people who are unhappy and/or anxious often avoid social contact. Likewise people who do not love other people tend to avoid their company, and people who do not trust others tend to have difficulty forming close friendships. It has been demonstrated that torture 402

can cause these and many other problems. In Melbourne, the Foundation for the Survivors of Torture lists the problems experienced by those who have suffered torture as:

1. Sleep problems and nightmares

2. Unexplained feelings of nervousness

3. Feelings of despair

4. Heart palpitations and sweating

5. Intrusive thoughts and memories that trigger feelings of fear and panic

6. Inability to trust other people

7. Isolation and lack of support

8. Feelings of fear and uncertainty

9. Emotional numbing and loss of enjoyment

10. Poor appetite and lack of energy

11. Overwhelming feelings of anger and sadness

When one compares this list with the “symptoms and signs” of “chronic schizophrenia” and “major depressive illness” more similarities than differences are evident. This could be interpreted as being due to “coincidence” or because torture results in chemical imbalances. More logically it could be 403

argued that schizophrenia and depression can result from torture as a result of psychodynamic processes – such as remembering traumatic events, being dispossessed and deprived of family and friends, negative racial, religious and social prejudices and so on. Torture can include being imprisoned without guilt; it can include being injected with a range of painful or crippling chemicals, electric shocks to various parts of the body, ‘surgical’ mutilation or personal humiliation by a range of stigmatising labels. These methods of torture were researched and practiced extensively in Nazi Germany during the horrible years of the Second World War. Enslavement, cruel punishments and terrorism were part of the range of abusive treatments that can be classed as “torture” which were part of the Nazi strategy for world domination. Indoctrination and “brainwashing”, which fundamentally destroy freedom of thought and expression, are recognised as abusive treatments – often directed at the youngest members of society.

There can be little doubt that early childhood experiences can have an effect on people’s self- confidence, sense of responsibility, trust in others and other “personality characteristics”. So can recent experiences. One need not look for chemical explanations to understand the causality and dynamics of many psychological phenomena, and, in fact, chemical ‘explanations’ may confuse, rather than clarify, understanding of many facets of human and animal psychology.

In this chapter I have tried to integrate some of the pieces of the catecholamine and indole amine puzzle, looking in particular at their known activity in the midbrain. The bigger picture of emotions, the brain and the mind, in which chemical theories can be seen in perspective, includes much that has nothing to do with chemicals. The joy of making a new friend, of finding a beautiful shell on the beach, of gazing at a picture, or a tree, or a face may be analysed in terms of dopamine stimulating the amygdala but such is not a very helpful analysis. While it is possible to hypothesise that this intensity (the difference between disliking and hating, fear and terror, or liking and loving) can be explained in terms of the strength of electrical activity or the level of dopaminergic or serotoninergic activity, such a hypothesis is seriously limited, and at most a partial explanation of one aspect of the physiology of emotions.

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Any meaningful hypothesis about the brain’s activity needs to include both electrical and chemical activity – including any meaningful amine hypothesis. The brain’s activity, let alone that of the mind, cannot be explained, though, by electrical, chemical or electrochemical activity disconnected from other aspects of physiology (such as movement and circulation) and from anatomy. Over the past few pages, some of the basic anatomy of the brain has been outlined, focusing on the known and speculated sites of action of the catecholamines and indole amines. The actual connections of the brain are obviously more complex than has been illustrated, yet already it should be apparent that the ‘dopamine theory of schizophrenia’, and the ‘dopamine theory of ADHD’ are seriously flawed and grossly simplistic. The ‘low serotonin’ (or low noradrenaline) theory of ‘depression’ is equally meaningless, other than to justify the prescription of serotonin and noradrenaline increasing drugs.

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LOOKING FOR LOVE AND EMOTIONAL HEALTH

How can love be studied scientifically? Is love something that can be used by doctors to heal patients, and for people to heal themselves – at least, of depression? Can love be used by doctors to heal themselves of depression? What about other psychological problems – could love of reading or writing (or drawing, or playing music) be used to improve concentration, and focus one’s attention longer? If so, love and interest could be valuable cures for “attention deficit” (actually, ADD is rarely diagnosed because of lack of concentration in itself – as we have seen, the criteria for diagnosis of ADD and AD/HD are centred on identifying and ‘treating’ defiance rather than deficit). And what about psychosis – could love of truth, objectivity and reality help dispel delusions? Could love of wisdom and knowledge prevent dementia – by motivating constant learning and growing awareness of oneself, others and the world?

Perhaps we should start by defining “love”, which is, itself, not an easy task. The second edition of the Heinemann Australian Dictionary defines ‘love’ as a verb and as a noun. As a verb, love is defined as:

1. To have a deep-seated affection for

2. (informal) to have a liking or enthusiasm for: ‘I love ice cream’

As a noun, ‘love’ is given four meanings (two similar to its use as a verb):

1. A strong passion or deep-seated affection

2. (informal) a liking or enthusiasm 406

3. A person who is beloved

4. Tennis: a score of nil

The sixth edition of the Concise Oxford Dictionary (1976) provides several alternative definitions for the word “love” as a noun and as a verb. The definitions for “love” as a noun include: “warm affection, attachment, liking or fondness, paternal benevolence (esp. of God), affectionate devotion” and “sexual affection or passion or desire, relation between sweethearts”, as well as “beloved one, sweetheart (esp. of women)” and “(in games) no score, nothing, nil”. As a verb, love is defined in this edition of the widely-used dictionary, as “hold dear, bear or make love to, be in love with, be fond of”, “be in love”, “cling to, delight in, enjoy having, be addicted to, admire or be glad of the existence of, (life, honour, comfort, golf, doing, virtue, man who knows his own mind etc.)”

The ‘definitions’ of love in the Concise Oxford Dictionary are not so much definitions as a catalogue of the many ways in which this noble word is used colloquially. If loving something means “being addicted to” or “clinging to”, then promoting love is not likely to be therapeutic for individuals or for society. If loving means sexual intercourse or lusting after others, if it means coveting or being possessive, again, no therapeutic benefits could reasonably be expected from encouraging people to be more loving. In fact, the reverse is likely to be the case – encouraging people to become more addicted to people or possessions, or encouraging people to be more sexually, emotionally or materially greedy, something that the mass media and the advertising industry are clearly guilty of, has had disastrous effects on our television-influenced society. Television mentions love a great deal, but has done little to elucidate its mysteries.

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The Greek language, in which ‘Western’ scientific terminology and concepts are rooted, contains three main words for ‘love’, erotos (eros), philia and agape. Freud seconded the former (eros) for his theory of human psychology, but ignored completely the more noble concepts (and phenomena) of philia and agape. Eros means ‘sexual love’ whereas philia means friendship and agape can be loosely translated as ‘non-sexual love’. The English language simply does not have one word to describe agape. The word refers to the love of parents for their children, and the love children have for their parents (which Freud would have us believe is ‘erotic’). Agape can also be used to describe love of virtue, or biology, or music, or history, or trees, or animals, or wisdom, or rivers, or flowers, or the sun, or the moon.

As far as emotions are concerned, love is an important – literally a vital (life-giving) emotion – and one that can be used therapeutically. There can also be little doubt that humans (and other animals) instinctually seek love from other humans (and animals). I am referring here, as I was in my previous work (unless stated otherwise), to agape (non-sexual love) and philia (friendship) when writing of ‘love’.

When I first tried to define love (for my own understanding of what I recognised to be an important word), I could not do better than, “a desire for the happiness, well-being, freedom and self-fulfilment of others”. This was in 1995, and I was 35 years old. I had just been released after almost 3 months in psychiatric hospitals, and was searching for a definition for the kind of love I hoped to see amongst humankind, and wanted to develop within myself. Prior to that I had used the word many times, but not spent much time pondering over what it meant. I had claimed to love chicken – but what I meant was that I enjoyed eating poultry. I had said, at various times, that I loved various (music) records, my guitar, catching butterflies, painting (and various paintings), waterfalls, fossils and cowries. I also thought that I loved my family, and indeed I did – but I had been taught from an early age that every child loves his or her parents that every parent loves his or her children (which is not true). I had also been taught that God and Jesus loved me (and everyone else) and that I should love God and Jesus (I was also taught that Jesus was God, something I had much difficulty grasping, at first, and later had much difficulty accepting). 408

Like many others of my generation I learned more about love from the movies and television, from pop songs and paperback novels than I did from my parents or my formal education. Nobody talked about love at home, as far as I can remember, and nobody taught us about love at school (other than learning various tenses of the verb amo – I love – in Latin). When I was at university, love was not mentioned in any of the many lectures and tutorials I attended, and it was not even mentioned in ‘psychology’ or ‘psychiatry’, despite the chapter on love in our prescribed psychology textbook.

Had I read this chapter when I was a medical student I would undoubtedly have read it less critically than I do today. I may even have, as I did with other textbooks, believed what it said as if it were gospel. I was, unfortunately for my sanity, brought up to regard “standard textbooks” in this way. Psychology and Life actually makes a credible attempt to define ‘love’, mentioning Erich Fromm’s work, after previously quoting Abraham Maslow, who said, wisely, “We must understand love; we must be able to teach it, to create it, to predict it, or else the world is lost to hostility and suspicion”. Under the subtitle “What is love, anyway?” the text continues:

“Another reason for the relative scarcity of research on love is the difficulty in defining it. Philosophers and social scientists have often differed on what are the components of love and on what forms love takes. The ancient Greeks distinguished between three types of love: eros or romantic love; philia, or friendship; and agape, which originally meant the love of God for humankind but now usually refers to humanitarian concern for people in general. In his classic book, The Art of Loving (1956), Erich Fromm proposed five different kinds of love: brotherly love (love of all humanity), parental love (love of parents for their child), erotic love (craving for union with one other person), self-love (love of one’s own being), and love of God (religious love).” (p.668)

Fromm’s categorisation of love refers only to ‘interpersonal’ forms of love – and not to love of such things as art, science, philosophy, history or peace. Even love of plants and animals is not considered part of the ‘art of loving’ in this analysis. It is thus not a truly holistic analysis of love – and fails to 409

identify many types of love (and objects of love) that are obviously of value in remedying depression (and sadness) and other psychological problems. Other academic analyses of love have been even more reductionist – and confused. Psychology and Life mentions Prescott’s “four aspects of love” and Berscheid and Walster’s (1978) analysis of the differences between “love and liking”. The latter psychologists argued that “fantasy plays a far more important role in love, while liking is more reality- bound” (implying that love is a delusional mental state), “love relationships can involve positive and negative feelings (e.g., loving and hating the same person), while liking relationships involve just one type of affect” and that “liking becomes more durable over time, while romantic love tends to weaken” (p.669).

Berscheid and Walster, like many other modern psychologists, refer to “positive” and “negative” emotions (feelings). Hatred is regarded as a “negative emotion”, while love is generally accepted to be a “positive emotion”. Likewise, happiness is seen as “positive” and “sadness” as negative. This categorisation seems to be both logical and “intuitively obvious”. Is it an absolute truth, though? If not absolute, can the categorisation of emotions into “positive” and “negative” ones be regarded as a “scientific” classification? Are these emotions ‘positive’ and ‘negative’ in a medical sense as well as a philosophical one? If people have more “positive emotions” does this make them more healthy, as well as more happy? What other emotions (other than love and happiness) can be regarded as positive, and which emotions are really ‘negative’? While fear may appear to be ‘negative’, there are situations where fear is of survival benefit. Likewise, while anger is often regarded as a ‘negative emotion’, this powerful emotion is an important force for social change – fuelling the struggle against exploitation, oppression and injustice.

Nevertheless, the problems that excessive and misdirected fear, jealousy, envy, and anger can bring are obvious – both to those who experience the emotion and those in their vicinity. It is equally obvious that irrational behaviour can result from excessive fear and anger, especially when they are present in the extremes of terror and rage. Fear, in its chronic form, is often described as ‘anxiety’ – and it is known that anxiety, itself disabling at times, also predisposes to a range of physical illnesses (including 410

stomach and duodenal ulceration, immune suppression and asthma). Hostility and aggression both result from unhealthy expressions of anger – and these, too, are known to be harmful for physical health, leading, ironically, to heart disease as well as other problems (Goleman, 1995). Hatred, one of the most obvious causes of warfare, is also part of the spectrum of ‘angry mental states’ – and so is jealousy (and envy). Another emotion that is clearly unpleasant and ‘negative’ is that of boredom – a common problem today.

It is clear, from even a cursory examination of common human emotions, that a ‘chemical explanation’ cannot satisfy a holistic search for the apparent function of the ‘limbic system’ – that of mediating emotions. Since what we see and hear obviously affect our emotions (which change in a far more dynamic way than neurological and psychological texts suggest), it is clear that any area of the brain that subserves emotional reactions must be neuronally connected to the visual and auditory processing areas of the brain. The limbic system, as described by Papez in the 1930s, satisfies this requirement – located as a ring-like structure in the core of the brain underlying the temporal lobes (see figs. 3a and 5). The temporal lobes, on either side of the brain, are involved in auditory perception, and contain the auditory cortex (involved in the processing and memory of musical, verbal and other sounds). The connections between these lobes and the ‘limbic system’ structures, and with the thalamus and basal ganglia (and the connections of these with each other) have been anatomically demonstrated (even though their functional connections have not been, so far, elucidated).

The limbic system is also directly connected with the hypothalamus – the basal area of the brain from which the pituitary gland is suspended. This anatomical connection explains why emotions have such a direct effect on both chemical and electrical aspects of physiology. The pituitary is directly connected, anatomically and functionally, with the hypothalamus, which controls the type and amount of hormones the so-called ‘master gland’ produces and releases into the bloodstream. The following diagram integrates some of the psychological and philosophical concepts discussed in the past few pages (and those to follow) with known midbrain physiology, focusing on known neural connections, neurobiochemistry and neuroendocrinology. 411

Fig 8: Physiology of emotions: integrated model

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The complexity of emotions defies localisation to a single part, or even a few parts, of the brain. Emotional reactions can be triggered by things we see or hear, things we smell or taste, things we imagine, things we remember and things we anticipate. This suggests that the areas of the brain that are involved in sensory perception, memory and imagination are functionally connected with those that subserve emotions. The fact that the same sensory stimulus (for example, a piece of music, or a photograph) can elicit different emotional reactions in different people, and different reactions in the same person at different times indicates some of the complexity of our emotional responses. In addition to differences in the type (kind) of emotional reaction, people also show great variation in emotional intensity, and, again, emotional intensity varies at different times in the same individual. In addition to ‘intensity’, particular emotions may be grouped as having a particular ‘tone’. ‘Emotional tone’ refers to more sustained, and general, feelings – also called ‘mood’. While many types of ‘abnormal mood’ have been defined, and are looked for in psychiatric assessments (such as irritable, ‘expansive’ and ‘elevated’ moods) there has been much less attention given to ‘good moods’ – a term and concept familiar to most people (from their own personal experience and daily observations of others).

The main structures and areas of the brain thought to be involved in emotional reactions, including their ‘tone’ and intensity, are presented in figure 8. Direct neuronal connections are shown as arrows, although some known, or postulated, circuits with relevance to emotions have been omitted, to maintain a manageable simplicity. Some connections shown as unidirectional arrows may, in fact, be bidirectional, and ‘structures’ shown as being connected with only one or two others, may, in fact be connected (neurally) with many more. The mammillary bodies (see figs 3b, 4 and 5) have been omitted, although these ganglia are known to play a central role in memory (specifically in encoding long term memory from short term memory), and memory obviously influences, and is influenced by, emotions and mood.

Memory is another important mental function that defies localisation to one part or a few parts of the brain, and creativity is likewise difficult to localise. ‘Imagination’ is also a ‘multiple area activity’, although knowledge of the areas of the brain involved in visual and auditory perception and imagery 413

can be used to make inferences about the neurological aspects of imagination and creativity. The visual, auditory and other sensory systems, of which detailed maps (neural circuits, or networks) have been made, also involve many parts of the brain (including cortical areas as well as midbrain structures). Voluntary movement, an essential requirement for the expression of ‘free will’, also involves areas of cortex (particularly the motor cortex of the frontal lobe) acting in concert with midbrain structures (particularly the basal ganglia) and parts of the ‘hindbrain’ (the cerebellum, especially). Voluntary movement also requires the functioning of efferent (outgoing) and afferent (incoming, sensory) nerves. The efferent nerves, which carry signals to skeletal muscle from the brain, stimulate muscles to contract and relax, while constant sensory input (which is transmitted to the parietal lobes via the thalamus) is necessary for control and modulation of voluntary movements (including information about the position of the moving parts – be they eyes, lips, legs, hands or fingers).

The integrated model presented in figure 8 includes the neural network (network of neural structures) that influence and/or are influenced by emotions as well as the connection that the limbic structures have with the hypothalamus and pituitary gland. Secretion of hormones by the anterior lobe of the pituitary is directly controlled by substances that travel to the lobe from the hypothalamus via a portal system of tiny blood vessels. The posterior lobe of the pituitary, which secretes oxytocin and vasopressin (anti-diuretic hormone) is directly innervated by the hypothalamus (Kandel, 1995, p.604). All three lobes of the pituitary secrete their hormones into the blood stream, which carries them to cells around the body. The anterior lobe, which secretes at least seven important hormones (see figure 9), modulates the glandular activity of other endocrine glands, including the thyroid, adrenals, ovaries and testes. Growth hormone, another anterior pituitary hormone, stimulates the growth of muscles, bones, and other tissues, while prolactin stimulates milk secretion during lactation. Growth hormone also has the effect of lowering blood sugar, while ACTH, by stimulating cortisol release by the adrenals, has the effect of raising blood glucose. Cortisol also acts as a natural immunosuppressant (hence the medical use of cortisone in various conditions where immune reactions are thought to be excessive (such as autoimmune diseases, eczema and asthma). The small middle ‘lobe’ of the pituitary (the ‘pars intermedia’) produces the hormone Melanocyte-Stimulating Hormone (MSH). This hormone stimulates melanin production by melanocytes, the pigmented cells that give colour to the skin and 414

eyes. The black pigment melanin is also present in melanocytes in various parts of the brain, notably the substantia nigra (that produces much of the dopamine in the brain) and the choroid plexus (which produces the fluid that surrounds the brain and fills the ventricle – the cerebrospinal fluid, or CSF).

Figure 9. The hypothalamus-pituitary axis, the pituitary gland and its hormones:

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The hypothalamus, an important collection of ganglia in the basal area of the midbrain, is also connected with the pineal organ, and activity in a specific nucleus within the hypothalamus, the suprachiasmatic (supraoptic) nucleus, is known to affect indole amine synthesis in the pineal. The pineal hormones, especially melatonin, are known to influence the secretory activity of the pituitary, and also to have effects on other parts of the brain (Wurtman, 1980; Reiter, 1983; Relkin, 1983; Becker, 1990; Arendt, 1995 and others). Specifically, melatonin is thought to inhibit the secretion of the gonadotrophin, luteinising hormone (LH) by the anterior lobe of the pituitary (which stimulates oestrogen production by the ovaries in women and testosterone production by the testes in men). Melatonin is also thought to influence the secretion of other pituitary hormones, including Thyroid Stimulating Hormone (TSH) and Growth Hormone (GH). Evidence of the pineal’s role (in mammals) in the immune system include studies that have shown increased development of cancer in pinealectomised rodents, and studies correlating the nocturnal secretion of melatonin with T- lymphocyte function (Arendt, 1995). It is presently unclear as to how much of the effect on the immune system is due to melatonin as opposed to other pineal substances, and it is also unclear as to which effects of the many claimed effects of ingested melatonin (such as sleep induction and mood changes) are due to direct physiological activity of the chemical, rather than secondary effects caused by melatonin affecting other brain chemicals.

The fact that the limbic system is directly connected with structures that control the endocrine system (notably the hypothalamus and pituitary) and the autonomic nervous system explains why emotions (and moods) have such a profound effect on health of the body – including effects on hormonal balance, involuntary (smooth muscle) activity (in the intestines, lungs, bladder etc), mineral and electrolyte homeostasis, temperature and blood pressure control, blood glucose (sugar) level and immune function. The fact that the limbic system is directly connected with the thalamus indicates obvious neuronal connections that facilitate effects on emotions (and the limbic system) by what we see and hear (and what we sense). This will be looked at in later chapters, along with the relationship between emotions, mood, motivation and movement. The connection between emotions and movement is neurally obvious in the close connections between the limbic structures (and system) and the basal ganglia, and the fact that both are stimulated, primarily, by the neurotransmitter dopamine. The damage done by dopamine-blocking drugs becomes even more evident. 416

The fact that many parts of the brain, including the hypothalamus, utilise serotonin, dopamine and noradrenaline as neurotransmitters explains why dopamine-blockers (also called ‘antipsychotics’/‘neuroleptics’), clozapine, amphetamines (and other stimulant drugs), tricyclic antidepressants and SSRIs cause a range of metabolic as well as neurological disturbances. These include disturbances of pituitary function (the hormone prolactin is especially commonly affected by dopamine blockers) and disturbances in pineal function. Furthermore, damage to the immune system, which can be predicted if the pineal is involved in immune health, may not become evident until many years, or decades, have elapsed (and even then may arise in the form of cancers, which are easily misattributed to other causes).

The pineal provides a key connection between the indole amine and catecholamine hypotheses. The synthesis of the indole amine melatonin from its precursor serotonin (also an indole amine) requires the presence of the catecholamine noradrenaline.

For almost a hundred years the most highly respected members of the medical profession in the USA (and elsewhere) maintained that the pineal was vestigial – they claimed, despite a historical tradition to the contrary, that the pineal was no more functional in humans than the vermiform appendix of the intestines. The organ that had been thought to be the ‘seat of the soul’ by Descartes and the ‘spiritual’ third eye for seeing truth by the Indians and Nepalese, was relegated to the biological dustbin. There it remained, until the discovery of melatonin in 1958 by the American dermatologist Aaron Lerner at Yale University in the USA.

It is not possible to localise perception of truth to a single part of the brain, and thus the idea that the pineal is a “third eye for seeing truth” is either completely incorrect or only part of the complex human ability to differentiate truth from falsehood. Obviously we can recognise what we hear or what we read as being either false or true (although much of the time we are not actively making such judgements). We can deliberately read or listen critically, with a conscious effort to ascertain whether or not a particular claim or statement is true. This clearly involves many parts of the brain – including the visual 417

and auditory cortex (in the occipital and temporal lobes respectively), the frontal lobes, the limbic system, thalamus, reticular activating system and cerebellum. All of these areas are involved in sensory perception of what we see and hear (and imagine) and our accompanying emotional reactions. Located in the geometric centre of the complex circuits connecting these structures is the highly vascular pineal (the pineal is, next to the cortex of the kidney, the most richly vascular organ in the body). The pineal is definitely connected with the visual system via the suprachiasmatic nucleus of the hypothalamus, and probably with the auditory system and other sensory systems via the direct nerve pathways of the pineal stalk.

Although it is hard to see how the pineal, in itself, can perceive truth (or anything else), perception of truth (recognition of what is true) may promote physical health through the endocrine activity of the pineal and other glandular parts of the brain. Emotional health can promote health through these same connections – healthy emotional reactions and good moods are presumed, intuitively, to promote general health (of the body and mind) but it has not been scientifically demonstrated (in terms of physiology, endocrinology and anatomy) as to why this should be so.

It has been correctly assumed, for many decades, that satisfaction of instincts (instinctual drives and needs) results in pleasurable feelings, however the theoretical model shown on the next page differs from previous ones in the identification of instincts (and psychic needs) as communication, curiosity, play and seeking love, respect, self-esteem, security and control. Seeking love, according this model includes the seeking the development of one’s own love for the universe, for the world, for others, and oneself. Logic and commonsense suggest that this love, if it is to promote health, needs to be balanced – a person who loves themselves but fails to love others and the other living and non-living aspects of their environment cannot be guaranteed a happy, healthy life. A person who loves only one person, or a few people, or only those of a particular religion, race, age or gender may contribute more to warfare than peace and harmony.

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Figure 10: Mind-body healing mechanism

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FREEDOM OF MOVEMENT AND CHEMICAL RESTRAINTS

The term “neural network” is increasingly familiar these days, due to the application of the biological concept to computer technology (often discussing ‘artificial intelligence’) and modern brain-science textbooks, unlike older ones, also refer to “neural networks” (a term that is literally valid, in this case). The term “neural maps” is also used in the brain sciences, referring to a property of sensory systems rather than the theoretical construction of maps of nerve networks and connections. Kandel’s Essentials of Neural Science and Behavior (1994) says, of the brain’s structure and “neural maps”:

“The most striking feature of the sensory systems is that the spatial arrangement of the receptors in the peripheral sensory organs – the retina, the cochlea of the inner ear, or the skin – is preserved in point-to-point or topographic connections in the sensory pathways throughout the central nervous system. For example, neighboring groups of cells in the retina project on neighboring groups of cells in the thalamus, which in turn project on neighboring regions of the visual cortex. In this way an orderly neural map of the visual field is retained at each successive level of processing in the brain. Not all parts of the visual field are represented equally in this map. The central region of the retina, the area of greatest visual acuity, has a disproportionately large representation in the cortex because of the large number of neurons and synaptic connections required to process the detailed information.

“Likewise, the body surface is represented by a neural map in the somatosensory cortex. As in the visual map, not all areas of the skin are represented equally. Regions that are particularly important for sensory discrimination and thus densely innervated, such as fingertips and lips, have more massive connections in the cortex and thus occupy the largest areas of the cortical map of the body. The auditory system has a unique neural map for sound….In the motor pathways, neurons that regulate adjacent body parts are clustered together, thus forming a motor map, which is particularly distinct in the primary motor cortex. As in the sensory maps, the motor map is not a one-to-one representation of the body. Some parts of the body, particularly the hands, are more finely controlled than others and so are disproportionately represented in the cortex.” (p.87) 420

The “motor map” referred to in this book is a presumed “possession” of the precentral gyrus of the frontal lobe – the gyrus immediately anterior to the central sulcus. This part of the frontal lobe is known to contain the cell bodies of the large majority of “motor neurones” in the brain and is thus also called the “motor cortex”. “Motor”, in a biological sense, is a general term referring to “movement” and it is clear that motor neurones are directly involved in making voluntary movements. The “neural map” of the motor cortex is commonly depicted as a “homunculus” (little man). Similar maps have been hypothesised for other mammals, mainly by electrically “stimulating” different parts of the cortex with probes. Monkeys, chimpanzees, dogs and cats have been experimented on in this way since the 1950s and before, and the human motor and sensory cortex have also been studied using the same technique. “Brain localization” by electrical stimulation is often regarded as having been pioneered by the Canadian neurosurgeon Wilder Penfield in the Montreal Neurological Hospital in the 1950s and 60s, though the first such experiments on human brains were done in German hospitals during the 1890s (Stone, 1997).

The neural connections between the basal ganglia and motor cortex are well established, although their functional relationship is not as clear. The American neuroscience textbook Essentials of Neural Science and Behavior (1995) explains:

“The extensive linkage between the basal ganglia and the cerebral cortex in both directions is believed to include several functionally and anatomically distinct circuits responsible for regulating limb movements, eye movements, and more complex cognitive behaviors. The best understood circuit arises in the corticostriate pathway from those portions of the cerebral cortex most closely related to the control of movement (supplementary motor area, premotor cortex, motor cortex, somatosensory cortex, and the superior parietal lobule). This pathway provides dense, topographically organized inputs to the motor portion of the putamen.” (p.547)

The other brain structure (apart from the basal ganglia and motor cortex) of importance to movement is the cerebellum, a phylogenically ancient structure attached to the brainstem, positioned in primates under the occipital lobes. The cerebellum is directly connected with the spinal cord and basal ganglia, 421

and with the motor cortex (via the thalamus). Essentials of Neural Science and Behavior (1995) summarises the “overall view” of voluntary movement as follows:

“The primary motor cortex is the nodal point for mediating the influence of higher sensory systems on movement. It is essential to organizing movements in which somatosensory input plays a controlling role, such as the manipulation of objects. Motor areas of the cortex also mediate the influence of vision on movement, as when we reach for an object or modify our walking to avoid obstacles.

“The basal ganglia and the cerebellum are the major constituents of two important subcortical loops of the motor system. Both receive substantial projections from the cerebral cortex and both project back to the cortex via the thalamus. There are three differences, however, in the cortical connections of the basal ganglia and those of the cerebellum. First, the basal ganglia receive inputs from entire cerebral cortex; in contrast, the cerebellum receives input only from that part of the cortex that is directly related to sensorimotor functions. It also receives highly specific information from the periphery. Second, the output of the cerebellum is directed back to the premotor and motor cortex, whereas the output of the basal ganglia is directed not only to the premotor and motor cortex but also to the prefrontal association cortex. Finally, the cerebellum receives somatic [from the body] sensory information directly from the spinal cord and has major afferent and efferent connections with many brain stem nuclei that are directly connected with the spinal cord. In contrast, the basal ganglia have relatively few connections to the brain stem and no direct connections at all to the spinal cord.

“These differences suggest that the cerebellum directly regulates the execution of movement, whereas the basal ganglia are involved in higher-order, cognitive aspects of motor control, namely the planning and execution of complex motor strategies. In addition, because of their extensive connections with association cortex and limbic structures, the basal ganglia, unlike the cerebellum, are involved in many functions other than motor control.” (p.549)

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What of the relationship between voluntary movement and free will? Needless to say, knowing about “free will” is not considered to be an “essential of neural science and behaviour”. The textbook explains the motor connections but does not integrate them with knowledge of emotional circuits, let alone discussing broader aspects of voluntary movement and the relationship between emotions and movement, while it is obvious that particular emotions can stimulate or inhibit movement. The fact that the dopaminergic basal ganglia are involved in regulating, modulating and coordinating eye movements is mentioned, but not the fact that abnormal eye movements in people on dopamine- blocking drugs is routinely being blamed on “schizophrenia” and cited as evidence that the “illness” is caused by brain abnormalities. The fact that what we see and hear can influence what we feel and what we do is not explored in this textbook or any other medical textbook I have examined.

The thalamus acts as a sensory integration centre for the visual and auditory systems, and is connected, also, with the noradrenergic ‘reticular activating system’, the basal ganglia, cerebellum, hypothalamus and various parts of the cortex. The ‘anterior nucleus of the thalamus’, regarded as part of the ‘limbic system’, is thought to be specifically involved in emotional reactions, although the exact functions of the thalamus, though known to be extremely complex (as suggested by its structural complexity and intricate neuronal connections) are yet to be clearly elucidated. It is generally accepted that the (bilateral) Lateral Geniculate Nuclei (LGN) act as integration and relay centres for visual information and that the adjacent Medial Geniculate Nuclei (MGN) serve a similar function in the auditory system. It has been shown that auditory signals entering the brain via the auditory nerves (from the cochlea of the inner ear) are carried to the MGN before radiating to other parts of the brain. Visual information entering the brain via the optic nerves, after crossing at the optic chiasma (above the pituitary), is transmitted to the LGN, from where it, likewise, is radiated elsewhere. Most of the auditory signals from the LGN are thought to travel to the temporal lobes (auditory cortex) and most of the visual data to the occipital lobes (visual cortex).

The connections between the nuclei within the thalamus and between these nuclei and various limbic structures provide a neuroanatomical reason as to why what we see and hear affect how we feel (our emotions). It does not explain why we feel what we feel (the variations of emotions) or the intensity of our feelings. 423

Figure 12. The thalamus, its location and neuronal connections:

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The following diagrams are theoretical explorations of how what we see and hear affect us. They are based primarily on psychodynamic and neuropsychological analysis and inductive reasoning, rather than chemical-oriented explanations. Figure 13, examines how what we see affects us, and figure 14, how what we hear affects us.

Figure 13. How What We See Affects Us:

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Figure 14: How What We Hear Affects Us:

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Figure 14 is an integrated model of the known “neural network” involved in perception of sound, with some added hypotheses (regarding the pineal and the detailed functions of the neocortex in particular). The diagram is centred on the known neural connections of the thalamus. This collection of nuclei in the midbrain is connected with the basal ganglia, hypothalamus, limbic system, reticular activating system and cerebellum, as well as with all the lobes of the cerebral cortex and all sensory inputs. The medial geniculate nucleus (MGN) and lateral geniculate nucleus (LGN) are attached, adjacent to each other, to the posterior (occipital) end of the thalamus. The two thalami, positioned bilaterally on either side of the third ventricle are connected with each other via the interthalamic connection, a tract of white matter that bridges the third ventricle.

The thalamus is recognised to act as a sensory integration and relay centre as well as having several other functions. It is this function as a sensory integration centre that is focused on in figure 14, particularly between auditory and visual signals. While it is obvious that what we see and hear affect our emotions, the known neurological connections between the thalamus and the limbic system point towards significant effects on our entire physiology because of what we see and hear. This is because the limbic system and thalami are directly connected with the hypothalamus and influence its activity. The hypothalamus affects the activity of the autonomic nervous system and the endocrine system, which in turn regulate a vast range of physiological activites thoughout the body. The analysis of “positive emotions” and “negative emotions” at the bottom of the diagram has been previously discussed, but in this diagram an analysis of “negative emotions” is expanded and extrapolated, indicating how unreasonable fear and unjustifiable anger (‘negative anger’) can lead to behavioural and attitudinal problems: avoidance, inactivity, boredom, jealousy and cowardice. These, it is postulated, can lead to dementia, depression and premature death.

On the other hand, responding to urges for movement that result from what we see and hear can lead towards health. Whether movement leads towards health or illness depends on what we do. This is obvious, because inactivity, as opposed to necessary rest, is clearly not healthy. It is equally obvious 427

that people can do things to harm their (and others’) health, and they can do things to promote their own health (and that of others). So what sort of movement is healthy, and what sort is unhealthy?

Purposeful movement is an essential for human health (and for other animals that are capable of purposeful movement). Purposeful, or voluntary movement is necessary for looking and speaking, as well as for walking, working, and socialising. It is necessary to move voluntarily to find things to eat, to meet other people and to interact with the world. To move requires energy and it requires the contaction of voluntary muscles.

A young doctor recently defined “free-will” for me as “the ability to selectively focus one’s attention”. I had never thought of free-will in this way and I immediately liked the simplicity and profundity of the definition. Given such a definition it becomes considerably easier to identify factors affecting free-will in modern society. If one is misled into thinking false ideas, or distracted from the truth – even being distracted from one’s own thoughts – this is, by this definition, an interruption of free-will. Being programmed or “brainwashed” (rather than educated and informed) is likewise an abuse of free-will. Being commanded to look at something or not look at something also infringes free-will, if the freedom of movement of one’s eyes is looked at in this way. Being coerced to say something, agree with something or believe something against one’s will means being denied free-will. Free will is a fundamental human right, but something possessed by only a few in modern society. Many do not even seek to achieve free will or freedom of thought and action.

The difference between looking and seeing is frequently unappreciated. Anyone with intact eyes and a functional visual cortex can see, but looking involves more – it requires an act of will. Yet looking comes to us and to other mammals naturally. We have eyes that are capable of a complex range of movements, including looking into the distance and focusing up close. The eye movements that enable us to understand visual aspects of the world (and non-visual aspects, as can be acquired by reading) include intrinsic (within the eye) and extrinsic (outside the eye) movements. Intrinsic movements include relaxation and contraction of the muscles of the iris and the muscles that regulate the thickness 428

of the lens; these are under autonomic control. The extrinsic muscles, which move the whole eyeball within the eye socket, are voluntary muscles innervated by three pairs of nerves that exit directly from the brain. These are the third (oculomotor), fourth (trochlear) and sixth (abducens) cranial nerves, often referred to in Roman numerals (cranial nerves III, IV, VI).

Visual movements are essential for aesthetic perception of colours, form, line and texture. Without movement of the eyes these cannot be appreciated. Perception of beauty in what is seen is thus dependent on eye movements, which are, in turn dependent on activity in these cranial nerves and their ganglia. What we choose to look at is not, however, determined by the brainstem ganglia that contain the neurons whose axons form the oculomotor, trochlear and abducens nerves. This is determined by the mind, and involves combined activity in the frontal lobes, thalamus and basal ganglia. The mind cannot be localised to any part of the brain (any more than soul or spirit can), but certain parts of the brain are specifically involved in enabling particular mental functions. Furthermore, damage to specific parts of the brain predictably, and reproducably, produce specific mental deficits. These can involve deficits in memory (and learning ability), emotional reactions and sensory ability (in various senses). For example, damage to the occipital lobes at the rear of the brain (see figure 3a) predictably results in visual loss even if the eyes and other parts of the visual system are intact. Damage to the temporal lobes can, because they contain the auditory cortex, lead to hearing loss, even if the ears themselves are healthy. Loss of use, however, results in subsequent degeneration of the relevant sense organs, as lack of use generally leads to atrophy of cells.

The relationship between the mind and movement is obviously connected with the relationship between the brain and movement, but they are not the same thing and when explored independently and then integrated tell us more than when either is analysed alone. Firstly, considering the relationship between the mind and movement we can look at purely psychodynamic processes and also the relationship between the mind and the brain. For example, we might look at why liking the appearance of the sea can lead to greater mental health by increasing motivation to walk on the beach, and develop a greater interest in the birds on the beach, the life in the water and the plants on the shoreline. This is a purely 429

psychodynamic analysis and theory that, based on inductive reasoning, is logical, rational, and potentially valuable for medical as well as psychiatric treatment, especially when the psychodynamic principles involved in this example are applied more generally (in terms of increasing motivation by cultivating interest, increasing knowledge by broadening perspective and seeking new learning experiences, increasing walking and enjoying contemplative, relaxed, physical activity) and specifically (in terms of individual needs).

The influence of the mind on movement and movement on the mind is reciprocal – our voluntary and involuntary movements affect our mental state and our mental state affects our voluntary and involuntary movements. The nutrients and chemicals we ingest also affect our capacity for movement, and also affect our minds in closely-studied ways. The effects of mental processes on the chemical and electrical movements within the brain have also been studied, but not in as much detail, and with strong biases against recognition of the influence of the mind on the body, as opposed to the much-publicised effects of the body on the mind. The latter include effects of various drugs, minerals, vitamins, herbal preparations, ‘tonics’, ‘nutritional supplements’ and ‘health foods’, the range of which grows daily on supermarket shelves and drug stores (pharmacies). Many of these are claimed to counter anxiety, depression, stress, insomnia and other mental problems, assuming that chemicals are of primary importance to mental health. In truth, voluntary movement is of far greater importance to mental health than chemicals, and the most aggressively marketed drugs today worsen mental health rather than improve it. They also tend to restrict movement and free will rather than liberate them, not least because many of these drugs have been developed for this precise reason.

To ‘understand’ the medical approach to movement, one requires a splintered mind, because the study of movement is divided between neurology, orthopaedics, physiology, rheumatology, psychiatry and several other specialties, all focused on illness and disease rather than health.

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Although the electrical stimulus for movement (within nerves) was discovered before the chemical stimuli, over the past fifty years the focus of medical research of movement has been centred on the activity of neurotransmitters, the chemical messengers that carry signals across synapses. Thse include the “biogenic amines” noradrenaline, dopamine and serotonin. These (and many other biological molecules) are essential for any vertebrate life (and much invertebrate animal life also). The first neurotransmitter to be discovered, acetylcholine (ACh), is not an amine, but like the biogenic amines it is essential for vertebrate life. Acetyl choline is synthesised from choline, an important molecule that is obtained from the diet (it is found in vegetable and animal fats) and is also manufactured in the body (Goodman & Gillman, 1985, p.1565). Choline is, interestingly, also produced by bacteria in the intestines, which assist us to acquire this important substance which is an important component of mitochondria (energy-producing organelles found in every cell) and of many lipids (including those that maintain the integrity of cell-membranes) as well being a precursor molecule for the synthesis of acetyl choline. In human, and other vertebrates, acetyl choline is the main neurotransmitter active at neuromuscular joints – the junction between nerves and voluntary muscles. This means that voluntary movement is impossible without acetyl choline.

The contraction and relaxation of muscles is directly controlled by neurones in the motor cortex (precentral gyrus) which generate electrical signals that are conducted along extremely long axons to the muscle fibres. At the junction between the axon terminal and the muscle cell (the neuromuscular junction) the neurotransmitter acetyl choline is released. This stimulates contraction or relaxation of the muscle. For this reason drugs that block acetyl choline receptors can also interfere with movement (in fact, they can cause complete paralysis, and are used for this reason during anaesthetics).

Acetyl choline is also the main neurotransmitter active in the synapses and ganglions of the parasympathetic branch of the autonomic nervous system (thus influencing the activity of various internal organs) and is also produced in the brain and spinal cord (the central nervous system). The seventh (1985) edition of Goodman and Gillman’s authoritative textbook The Pharmacological Basis 431

of Therapeutics explains how research on the neural activity of various amines has been researched, giving also an insight into why this style of science is unlikely to cure human (or animal) anguish:

“The evidence for cholinergic [acetylcholine mediated] transmission in autonomic ganglia is similar to that obtained at the neuromuscular junction of skeletal muscle. For example, when the perfusate from the isolated cat superior cervical ganglion is tested, ACh appears in the perfusion fluid after preganglionic but not after antidromic [in the opposite direction to normal] stimulation; it is not liberated spontaneously in significant amounts. The ganglion cells can be discharged by injecting very small amounts of ACh into the ganglion.” (p.81)

These studies, in which cats were killed and their ‘isolated’ superior cervical ganglia ‘stimulated’ (electrically) does, indeed, strongly suggest that acetyl choline is contained in these ganglia and active as a neurotransmitter in the pre-ganglionic synapses of the sympathetic branch of the autonomic nervous system, but how does this knowledge help us? It has obviously not helped the hundreds of cats that have been sacrificed for this information. Disconnected bits of information (even if factual) about the biochemistry of the nervous system, are of little use without integration – we end up with jumbled pieces of a jigsaw puzzle to which more pieces (some from other puzzles, and some that are intentionally confusing or misleading) are added before we have constructed a meaningful framework to understand the pieces we already have. This is the situation we have in the neurosciences today, with over 50 different neurotransmitters ‘discovered’, together with hundreds of other chemicals known to be secreted or active in the brain: neurohormones, endogenous opiates, regulatory factors, cytokines and so on.

Since the brain is an integrated unit, even if our science of it is not, all the ‘neural networks’ in the brain are, ultimately, just parts of the single neural network, and the chemicals that facilitate the movement of electrical signals need to be seen in perspective as a small part of the physiology of the brain. In the study of movement, though, mechanistic models are probably more appropriate than in the study of emotions (accepting that movement and emotions are related in many ways and that there are 432

still problems with a mechanistic view of movement). Evidence that both the motor cortex and the basal ganglia are involved in initiating, continuing, and changing intentional actions is overwhelming. Details of the “motor pathways” connecting the motor cortex with peripheral nerves have been standard information in brain science textbooks for several decades. The connections between the basal ganglia and the motor cortex have also been elucidated, as have the main pathways of the visual and auditory systems. What has not been done, however, is the integration of these fragments into a meaningful whole – and, most significantly, the emotional circuits of the brain have not been adequately integrated into any of the other better known pathways (such as the motor, auditory and visual pathways). This is the case even when the actual anatomical connections are obvious – as they are in the case of both the visual and auditory systems.

Voluntary movement, including eye movements and speech movements is intimately connected with freedom of action. Without movement there can be no action, and without the contraction and relaxation of muscles there can be no voluntary movement of the face, limbs or any other part of the body. This movement requires the activity of acetyl choline and catecholamines, particularly dopamine, in the brain. Any drug that blocks dopamine receptors can, therefore, be expected to impair voluntary movement – at its ‘source’. They are thus effective (though unpleasant and dangerous) chemical restraints. Although they stop people from talking about things that annoy or upset other people, this is because they inhibit the movement of the mouth and tongue thus making any speech difficult. By blocking dopamine receptors in both the limbic system and the basal ganglia they also interfere with the more emotion-driven urges to movement and dull emotional reactions generally. They also cause fatigue, lack of energy and drowsiness – these may have the effect of making ‘noisy’ people quieter and more controllable (‘settled’ is a popular term among nursing and medical staff), but drugs used in this way can hardly be described as “medicines” – rather, if these drugs are used as chemical restraints, patients, their families, medical and nursing staff and the general public should be aware that this is the case, without disguising the truth with euphemisms such as “antipsychotics” or even “tranquillisers”. Dopamine-blockers seldom, if ever, make people feel tranquil, and they certainly do not cure psychosis.

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It is possible, however, that dopamine-blockers (which appear to interfere with creative, lateral and associative thinking) can quieten auditory hallucinations. For this purpose only a fraction of the commonly used doses is necessary and other (non-drug) approaches are probably safer and more effective. It should be noted that dopamine blockers and other psychoactive drugs (especially stimulants, such as amphetamines, LSD, SSRI antidepressants and MDMA) can also trigger or aggravate hallucinations. Particular audiovisual stimuli can also trigger hallucinations as can sensory- deprivation and torture. These will be discussed further in a later chapter. I have never experienced auditory hallucinations myself but have no doubt that they occur, and are created by the brain itself rather that as the result of ‘channeling’, ‘possession’ or telepathy (see pp 81-93). At the same time it is clear that many people would rather live with, or control by their own free will, what others might regard as ‘hallucinations’. Some regard their experiences as ‘visions’ or ‘voices’ of divine or ‘supernatural’ origin. While they may be deluded in this belief, forcing them to take dopamine-blockers is not justifiable medically, ethically, socially or legally unless these experiences are a direct and immediate threat to themselves or others.

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MIND OVER MATTER OR MATTER OVER MIND?

Despite a constant tendency to “splitting’, specialisation and subspecialisation over the past four centuries, scientific knowledge is not completely splintered. In fact, the sciences of psychology, biology and medicine have, over the past 400 years, produced many integrators as well as (many more) ‘splitters’. It must also be admitted that the information that is subsequently integrated into a meaningful whole can often only be acquired by specialisation, reductionism and splitting. Such is the case with the neurosciences, however the fact remains that splitting has overtaken integration. Furthermore too much splitting is problematic, especially if one has lost sight of what is being split, and why it is being split. In the neurosciences this results in an inability to piece together a whole picture and gain a balanced perspective of the brain and its most obvious activity – thinking. So let us consider, briefly, the relationship between activity of the brain and activity of the mind.

It is a basic neuroscience assumption that the mind is the product of activity in the brain, and is effectively located in the brain. The fact that ingested chemicals and injected chemicals which are known to affect chemical and electrical activity in the brain have corresponding effects on the mind supports this assumption, as does the fact that physical injury to the brain affects mental function (in its extremes causing loss of consciousness or death).

It can be said that the only parts of the brain that is directly visible from the outside are the eyes. The eyes develop in the embryo as outgrowths from the developing brain to which they retain intimate connections, structurally and functionally. The processes occurring withing the brain are directly reflected in the movements of the eyes and light entering the eyes has profound effects on activity within the brain. This activity includes both electrical and chemical movements and changes, and somehow results in the formation of memories of what has been visually perceived as well as emotional reactions to what has been seen (along with what has been remembered or imagined because 435

of what has been seen through the eyes). Understanding these processes requires an exploration of the relationship between the brain and mind, since the visual pathways are part of the brain, but seeing and understanding are done by our minds.

Although there is little controversy regarding what constitutes a person’s brain, there is less agreement regarding what constitutes the mind, thinking and thought. Everyone is, however, familiar with what it means to think about something, so it seems a good place to start a discussion of the mind. When we are awake, we are obviously able also to think about the fact that we can think – we can analyse our thought, ponder over our memories, and remember our dreams (at least some of them). Humans are, by this token, self-aware or sentient beings – we are aware of our own existence as well as our ability to think. The fact that we dream when asleep indicates, firstly, that the brain is active when we are not awake, and secondly, that the mind is also active. Freud and Jung, the physicians who pioneered modern psychoanalysis in the early 20th century, referred to this mental activity as “unconscious” – and regarded dreams as a window into the workings of the ‘unconscious’, and, in Jung’s view to what he called the ‘collective unconscious’. Both these doctors developed elaborate theories on the interpretation of dreams based on their own (highly subjective) assumptions about symbolism in dreams. These theories became core assumptions of Freudian and Jungian psychoanalysis, in which, unfortunately, the speculative theories of Freud and Jung have been made into dogmas akin to religious dogma (but without the accompanying morals and ethics). The fact remains that dreams are an indication that the mind does not stop when we are asleep.

The theories of Jung, Freud and other “medical psychoanalysts” were “self-contained” psychodynamic theories – they attempted to explain behaviour in terms of unconscious and conscious mental factors (such as memory and motivation). There was no integration of chemistry into their models and they also did not connect what goes on in the mind with what goes on in the various physiological systems (the cardiovascular, immune, respiratory etc).

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Freud’s and Jung’s style of psychology was centred on words rather than numbers, and they attempted, with variable degrees of success, to present logical word-based arguments to justify their conclusions. This style of science can also be used to approach the known biochemistry of the human body (including the brain and nervous system), and, in fact, every biochemical hypothesis must, inevitably, be framed in words (every chemical hypothesis need not be). The reason words are so essential to biochemical hypotheses is that the natural language of biology is words rather than numbers. Naming, defining, recording observations accurately and arguing logically in words are the time-honoured fundamentals of biological science. While not denying that numbers can be used in biology, they are not as important as numbers are in physics and the inorganic sciences.

“Biology”, the study of life, is fundamentally divided academically into the study of plants (botany) and the study of animals (zoology). It is generally assumed that plants do not “think”, while “higher animals”, including humans, are capable of “thought”. The study of human biology is actually part of the larger field of zoology, but the two have evolved into two very different disciplines, which do, nevertheless, share core assumptions. One of these assumptions is that of evolution by natural selection, as described by Darwin and Wallace in the 1860s. Darwin and Wallace were zoologists, and their work was primarily concerned with plant and animal evolution. Both regarded humans as fundamentally different from other animals – and both were wary of the reaction from the Christian Church to ideas that humans and other animals shared ancestors. Wallace avoided, in fact, entering the such dangerous waters, and Darwin did so only with much trepidation in his later work The Descent of Man.

At the time of Wallace and Darwin the medical profession was already a powerful force in Britain, and Britain was a powerful force in the world. The Royal College of Physicians had been established back in the 1500s, and had continued to regulate the medical profession throughout the era of colonial cargo slavery. It is evident that the organisation was not a powerful force for emancipation of slaves, and neither was it a voice of the oppressed. And there were plenty of people being oppressed by the British 437

Empire, at the time, who needed a voice. This has relevance to the profession’s subsequent views on freedom of thought and action amongst the “masses”.

Although Freud and Jung were medically trained, they approached psychology in a different way to their colleagues – they looked for causality in the unconscious mind rather than in the brain. They were, as most physicians before them, preoccupied by mental dysfunction and disturbance than by an understanding of health. This is not surprising – the medical profession is trained to look for, diagnose and treat disease. Promoting health has not been part of the cultural tradition of the medical profession, and only in relatively recent times has “preventative medicine” become a recognised responsibility of the profession. As a result of this, “preventative medicine strategies” have been rooted in a tradition of increasing, rather than decreasing, concern of, and fear about, illness. This is clearly evident in a wide range of “health promotion campaigns” in Australia (and elsewhere) where the focus is on increasing “disease awareness” and promoting the “availability of treatment”. The most prominent of these strategies, in modern times, have been directly or indirectly sponsored by the very drug companies that market drugs for the promoted illness. These campaigns routinely ignore the influence of the mind on the body and promote the idea that drugs are underprescribed rather than overprescribed – for both mental and physical problems.

A second type of unconscious brain activity that might be regarded as being part of the ‘mind’ is that which regulates the activity of the internal organs via the autonomic nervous system and endocrine system. This activity, regardless of whether it is termed ‘unconscious mental activity’ or not, is vital for health, and dysfunction in these systems is known to cause serious health problems. Although it might seem that because the autonomic nervous system, endocrine system and brain are distinct entities they can be studied and understood separately, a close look at the nervous system reveals the division to be less clear. Firstly, the brain acts as an endocrine gland itself, and regulates, through chemical and electrical messages, the other endocrine glands. Secondly, the nerves which form the proximal sections of the autonomic nervous system originate in the brain, and the (largely unconscious) activity of the autonomic nervous system is also thus mediated, or even controlled, by the brain. 438

Does the brain also create and ‘control’ the mind, or does the mind control the brain and its function? This is a difficult question, and its answer penetrates to the core of theological and philosophical debate regarding free-will and causality. It also has much relevance to legal judgements regarding innocence and guilt. Are we the slaves of our brains or whoever controls our brains? Can people control other people’s brains and minds? How much responsibility do people have for their actions, and can people commit unintentional crimes? In terms of physiology, the question of whether brain dominates mind or mind dominates brain has relevance to important unanswered questions. Can worry about getting cancer cause cancer? Can worry about getting arthritis increase one’s risk of developing the disease? Can lack of new learning result in dementia? Can lack of love lead to heart disease?

To approach the relative dominance of ‘mind over matter’ or ‘matter over mind’ from a balanced perspective we must keep our mind open to the possibilities that mental activity can affect brain activity, and brain activity can affect mental activity, that mental activity can affect chemical and electrical activity and chemical and electrical activity can affect mental activity. In fact, there appears to be ample evidence of all of these phenomena in medical science, although most of the emphasis has been on the effects of chemicals (and the brain) on the mind. The effects of the mind on the chemical and electrical activity in the brain (and body) are not as easy to prove as the reverse, however the proof does exist. One source of evidence comes from various examples of the well-known “placebo effect” (first named as such by the ancient Greeks), whereby healing is known to be promoted by belief in the efficacy of a prescribed treatment and belief in the therapist.

The converse of the placebo effect is also easily recognised. People can be made unwell by convincing them that they are ill, and people can “make themselves sick by willing it on themselves”. People can also become unwell because of mental stress without wanting to become ill. Stomach ulcers, diabetes, high blood pressure and ischaemic heart disease are all known to be aggravated by mental stress. ‘Mental stress’ is now recognised as a serious health problem, and international conferences are held to highlight it. “Stress”, as it is often abbreviated to, is seen as a significant factor in recent increases in 439

depression and suicide. But what is mental stress, and why is it increasing? Is it actually increasing, or are people just less tolerant of stress than before? Is it just a new term for an old problem?

Mental (or psychic) stress cannot be accurately measured and is such a broad and variably used concept that it is difficult to define precisely. It is, nevertheless, frequently referred to, and books have been written about how best to treat stress, and about its many detrimental effects. One such book is Stress: how your diet can help by nutritionist Stephen Terrass. This is one of many ‘popular health’ books published by the Murdoch empire’s Harper-Collins publishing corporation (that also publishes the Aquarian series of New Age books, including Understanding Auras). Terrass, according to the biographical notes on the back cover, is “technical director for a leading vitamin company” and “has spent 15 years studying and researching the effects of nutritional supplementation, herbs and diet on health”. Consequently, it comes as little surprise that his remedy for “stress” involves the ingestion of vitamins and ‘nutritional supplements’.

The focus on ingested treatments is not exclusively a pharmaceutical and medical one – the vitamin and mineral supplementation industries and the herbal treatment industry have also put forward many substances for the treatment of stress, and made claims as extravagant as those of the pharmaceutical industry regarding their efficacy. By the way, many “vitamin and mineral supplement” manufacturers are actually pharmaceutical companies (which also manufacture and promote prescription drugs). An additional problem with vitamin and mineral supplements is that they are readily available on supermarket shelves and have even less rigorous controls regarding the scientific claims made about them than prescription drugs. A bewildering range of vitamins, minerals and herbs are said to help with “stress”.

The fact that ingesting chemicals (including alcohol) can affect mental activity is obvious – and it is equally obvious that what we ingest affects the biochemistry of the blood, brain and other parts of the 440

body. It is also true that mental activity affects biochemistry (and physiology, more generally). This is exemplified by the placebo effect, and by recent studies demonstrating a rise in serotonin levels accompanying success in set tasks (and accompanying increase in self-esteem). The latter has been demonstrated in both humans and other primates (chimpanzees) and is a most significant discovery, because it challenges a widely-held medical view that behaviour is governed by chemical changes rather than chemicals being governed by behaviour and thought. Another widely held view, which can be disproved logically (rather than experimentally) is that psychology (the science of thought) is defined as the “scientific study of behaviour”. While the scientific study of behaviour can certainly be included within the field of psychology, this is necessarily only a small part of the field. Thought itself can be studied scientifically.

The scientific study of thought and thinking (psychology) is, as has been mentioned, splintered into many schools, each with different dogmas and each using different terminology. Much of the literature of these different schools cannot be comprehended by one not initiated into the jargon and concepts of the discipline (as is the case with psychiatry). This makes it difficult for “lay people” to challenge the logic and the conclusions of the various schools of thought (as it is for non-mathematicians to challenge mathematical arguments). It is also difficult for people trained in different disciplines (or languages) to challenge the arguments on which various conclusions are based. ‘Decoding’ and demystifying medical and psychiatric jargon has been a primary objective of my work over the past five years – because through this I hope that the public can be empowered to critically evaluate the principles and practices of my profession.

The brain functions as a whole, in a presently mysterious way, and localising particular aspects of this function to particular parts of the organ, while scientifically valid, has an unfortunate history, that of ‘phrenology’. ‘Phrenology’ – from the Greek phren (mind) and logos (word) was the dominant force in European psychology in the nineteenth century – a ‘scientific discipline’ that sought to localise different mental functions to various parts of the (outside) of the head. Elaborate and fanciful maps were drawn demonstrating the ‘characteristic shapes’ of the heads of “geniuses” and “idiots”. Some 441

people were portrayed as having noses, ears and brows that showed their ‘criminality’ – and inferiority, while others were seen as having the ‘characteristic facial features of nobility (and superiority). Needless to say, the racial groups and social classes that devised phrenological maps used their own head shapes and facial features as the main measure of ‘superiority’.

Making judgements on the basis of head shape and size was carried to ridiculous extremes in the discredited technique of ‘craniometry’ – measurement of the cranium (of the skull) to ascertain intelligence and other mental qualities. Steven Jay Gould, in The Panda’s Thumb has written eloquently about bizarre efforts to prove the ‘inferiority’ of both ‘negroes’ (‘blacks’) and women using craniometry. After over a hundred years, the effort had to be abandoned because ‘blacks’ do not, on average, have smaller brains or skulls, and women have smaller brains than men only because they are, on average, smaller than men. Furthermore, the size of the brain (or skull) correlates poorly with intelligence, by whatever method intelligence is measured (and it has been measured in many ways – most of which have also been socially, culturally and racially biased).

The phrenologists, in addition to incorporating their prejudices into their theories, were guilty of a ridiculous degree of reductionism – this in pursuit of ‘taking a scientific approach’. The 1837 phrenological map of Theodore Poupin, for example, identified 35 separate ‘mental organs’, which were accorded specific areas in a mosaic-like map of the head. These included the ‘organ of destructiveness’ (at the back of the head), the ‘organ of secretiveness’, the ‘organ of hope’, the ‘organ of marvellousness’ and the ‘organ of causality’. He also marked two areas on the brow (on either side of the ‘organ of comparison’) as being the ‘organ of language’.

While the phrenological maps of the 1800s were based more on prejudices than sound scientific principles, the discovery, by Paul Broca, that there does, indeed, exist an area of the brain (now called Broca’s area) that appears to be specifically involved in the generation of speech indicates that at least some important mental functions are controlled by localised areas of the brain. Broca (1824-1880), the famous French neurologist (who was himself a keen craniometrist) presented, in 1865, several cases of 442

people who, following damage to a specific part of the left side of their brain, lost the ability to speak (but not to understand speech). He postulated that this area was specifically involved in creating speech, a theory that has now gained overwhelming evidence in its support. In 1874, few years after Broca discovered ‘Broca’s area’, the German scientist Carl Wernicke (1848-1905) showed that damage to another part of the brain (in the temporal lobes, posterior to Broca’s area, which is in the lower, caudal end of the frontal lobes) resulted in difficulty in or failure to understand speech (receptive aphasia).

The identification of Broca’s and Wernicke’s areas fuelled scientific efforts to identify the real functions of different parts of the brain without making the mistakes of ‘phrenology’. Using a range of techniques, different parts of the brains of humans and various animals have been intentionally damaged, with an intent to find out what the damaged part of the brain does. This has included surgical mutilation, chemical ablation and destruction of parts of the brain by cauterisation (burning) or electrocution (using electrical probes). Other evidence about brain localisation (of function) has been obtained through the careful examination and observation of people who have suffered brain injuries (through trauma or disease) – and this source of data continues to grow (along with collections of diseased brain tissue in the “tissue banks” of neuroscience research institutions).

Many of the people who have been studied to ascertain the cause of their aphasia (inability to speak) have suffered from cerebral infarctions (strokes) or traumatic injury to the brain, during which either Wernicke’s of Broca’s areas, having lost their blood supply, have suffered the loss of neurones. Since the advent of CT scans and other non-invasive imaging techniques in the 1980s the areas of brain that have been damaged by disease processes and injuries has become much easier than was the case before then, and, with the development of MRI (magnetic resonance imaging) and PET (positron emission tomography) the tools that can be used by neuroscientists to study the brain (without mutilating it) have been further advanced.

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The brain is not an amorphous organ – it is highly organised and structured in a complex by inherently systematic way. It is obvious from its structure that different parts of the brain do different things. This means that some degree of localisation of function to specific parts of the brain should be possible – and it is. However, many things that are obviously done by the brain cannot be localised in this way at least according to our present (limited) understanding of the most complex organ in the body. This does not make the search for specific functions (and localisation of them) futile, unscientific or unnecessary (despite the misguided efforts of the ‘phrenologists’). To understand the brain as a whole we must understand what the different parts of the brain do, as well as what they look like and how they are connected.

What remains to be done is to integrate the pieces of the puzzle that have been obtained though various means – to give us a means of using this knowledge to enrich human life and cure illness. Integrating what we already know can be expected also to give us a better perspective of where to draw the line between integration and splintering – and help us see the ‘bigger picture’.

For a balanced understanding of biology or of health it is important to maintain a holistic approach – meaning to maintain (or gain) a balanced perspective of the whole subject. This is important in many other areas of life as well – the wisdom of “looking at the bigger picture” is more than a popular idiom. A holistic approach, while now acknowledged as desirable by the ‘orthodox’ medical profession, requires substantial changes to the medical curriculum and a great deal of cooperative and integrative work between different medical specialties which is only now beginning in the more progressive institutions. A holistic, integrative approach is the very antithesis of the splintered, reductionist educational approach that medical students experience at university.

The British academic system is divided into several branches, with a deep separation between “the arts” and “the sciences”. This division is political and epistemological. The political division means that “arts courses” for people who want “arts degrees” are developed and taught in different ‘faculties’, and often, different institutions, from ‘science courses’. This epistemological division means that 444

people studying for ‘science degrees’ face difficulties in also studying “arts” subjects (such as history, geography, philosophy or politics). While there is more freedom to choose subjects depending on one’s interests and learning needs in some courses, in the undergraduate study of medicine in Australia and throughout the world students are given little freedom to choose what they learn (or to disagree with it). The system of examinations ensures that only those students who agree with what is taught (or profess to agree with it) are allowed to become doctors. This applies for psychiatric doctrines as much as for doctrines about the circulation of blood, the cause of cirrhosis or the best management for middle ear infections.

The system of qualifications that regulates the medical profession is extremely complex, and varies between nations. It is a global system, and is connected through the hundreds of universities around the planet. Of these universities, two are of great historical and political importance to the medical profession in Australia and throughout the world – in both English-speaking and non-English-speaking nations. These are the old English universities at Oxford and Cambridge. These universities were the first home of the Royal College of Physicians (founded in the 1500s by Henry VIII) and the institutions at which the King James’ Version of the bible was translated in 1611. They were the institutions that educated the Kings and Lords of England, and later, ‘Great Britain’. They educated the archbishops and the aristocrats of the British Empire and crafted the language and policies of the empire. The Oxford University’s definition of the meaning of English words is, and has for many centuries, been held as the absolute authority on semantics (the meaning of words).

So, coming full circle, to the city of my birth and the language of my masters, what did the Concise Oxford Dictionary of 1976 (the year I began school in Australia) contain as a working definition for schizophrenia?

“Schizophrenia (sk-; or skits-) n. Mental disease marked by disconnection between thoughts, feelings, and actions, freq. With delusions and retreat from social life; hence ~ e’nic a. & n. [mod. L, f. Gk skhizo to split + phren mind; see –IA] 445

Once one has dissected the codes and jargon the truth becomes clearer. The politics of schizophrenia are where the cause and cure of schizophrenia are to be found. The “split” minds at the root of this “mental disease” are those that have created “divide and rule policies”, fragmented educational establishments and programs, and emotional disconnection in the guise of “objectivity and keeping a safe distance from patients’ problems”.

In this book the inadequacies of monoamine theories on “mental illness”, and specifically the “dopamine-excess theory of schizophrenia” and the “serotonin-deficiency theory of depression” have been discussed at length. Nevertheless, drugs that increase serotonin and dopamine activity in the brain do have an effect on mood, and can obviously affect the mind in many ways. It is known that drugs that inhibit or stimulate catecholamine activity in the brain tend to also affect indole amine activity. For example, ‘tricyclic antidepressants’, which are usually described as ‘increasing noradrenaline levels’ also affect serotonin and melatonin (this is not surprising given that the conversion of serotonin to melatonin in the pineal is stimulated by noradrenaline). Likewise, amphetamines, which increase dopamine levels in the brain also affect serotonin levels, and SSRI drugs, which block serotonin reuptake mechanisms also affect catecholamine activity in the brain.

The blockade of dopamine receptors and stimulation of dopamine receptors (either by increasing dopamine release or mimicking dopamine at the cell wall receptor) by various drugs has been studied for several decades now, and it is clear that both stimulation and blockade of receptors cause complex changes in mental state and behaviour. It is also evident that drugs which affect the activity of other catecholamines (noradrenaline and adrenaline) can also cause psychic (mental) changes, and that, because the metabolism of these three catecholamines is interconnected, drugs that affect one catecholamine tend to also affect the entire catecholamine system. It is also known that many drugs that affect catecholamine activity in the brain affect indoleamine (serotonin and melatonin) activity too. The effects of various psychoactive drugs on melatonin levels illustrate this important phenomenon. The reductionism and splintering of the neurosciences has resulted, unfortunately, in a common failure to appreciate this point – those who are researching the pineal and melatonin levels are disconnected from 446

those who are researching serotonin, and those who are researching dopamine. Those who are researching the basal ganglia and idiopathic Parkinson’s disease are disconnected (often in different institutions or departments) from those who are researching tardive dyskinesia, schizophrenia and drug- induced Parkinsonism. It is little wonder that while many papers are published and many millions of research dollars spent, no cure for schizophrenia (or Parkinsonism) has eventuated from such a non- integrated, reductionist system. Of even greater concern the system is “profit driven”.

The drive for profits in the neurosciences research industry is focused on the development of drugs (mainly for humans but also for animals – recently vets in the USA have taken to prescribing Prozac for ‘depressed’ dogs, and even birds). In the case of schizophrenia, there are obvious and widely acknowledged problems with current drug treatment – and it is accepted, by those who are developing new drugs, that the dopamine-blocking drugs which have formed the mainstay of medical treatment for schizophrenia are unacceptably toxic.

The Chairman of the Mental Health Research Institute in Melbourne a few years ago, Ben Lochtenberg, who happened also to be the Chairman of ICI Australia Ltd (Orica chemicals and explosives) and directors of both Capral Aluminium Ltd and Melbourne University Private, wrote of the Institute’s “Research and Development Syndicates” in the MHRI’s 1997 Annual Report:

“The Anti-Schizophrenia Drug Research Project and the Electroencephalography (EEG) Research Project are both in their second year and running within budget. The latter is generating international interest and aims to develop new methods for analysing EEG. To date, it has produced the most powerful and extensive mathematical description of electrocortical activity in existence and the project is expected to meet its stated goals. The Anti- schizophrenia Drug Research Project is continuing its detailed research on a drug discovery program and aims to produce a better targetted drug for schizophrenia, without the side effects common in current treatments.” (p.8) 447

The common “side effects” (such as Parkinsonism, akathisia and tardive dyskinesia) are not further described in the Annual Report of the MHRI, nor is it admitted as to how similar these “side effects” are to the symptoms and signs of the illness (see pages 17-27). On the other hand, a plethora of studies have been done on diagnosed schizophrenics, some apparently before dopamine-blocking drug treatment was initiated, but mostly after such drugs have been used. Researchers at the MHRI have also gained publication of several papers analysing the growing collection of brain tissue samples of people diagnosed with schizophrenia who are now dead (see pages 58-62) with others “in press”. These include, according to the 1997 Annual Report, papers with the following titles:

1. Possible conformational changes in the serotonin transporter in the hippocampus of subjects with schizophrenia identified using [3H] paroxetine.

2. Neither protein kinase C nor adenylate cyclase is altered in the caudate-putamen from subjects with schizophrenia.

Other studies being done by the MHRI include extensive epidemiological studies of Victorian people – particularly those who are being treated for schizophrenia, Alzheimer’s disease and ADHD. The Institute is involved in developing drugs for the treatment of these conditions and is not seriously looking for cures – only drug treatments and diagnostic tests. In fact, if schizophrenia were to be recognised as a nasty label the “Molecular Schizophrenia Division”, The “Applied Schizophrenia Division”, “Clozaril Patient Monitoring System” of the MHRI would no longer have a reason for existence or a reason to ask the government and public for funds to look for the cure of the “cancer of the mind”. If Attention Deficit Hyperactivity Disorder were also to be recognised as a nasty label, studies such as, “Predictors of persistence of Attention Deficit Hyperactivity Disorder symptoms in a large-scale twin study”, “Twin-sibling differences in parental reports of Attention Deficit Hyperactivity Disorder, speech, reading and behaviour problems” and “Sex differences in genetic and environmental influences on DSM-III-R Attention Deficit Hyperactivity Disorder” would no longer be regarded as “mental health research”. 448

The MHRI 1997 Annual Report does not mention any studies on melatonin and the pineal, although serotonin is mentioned frequently, as is dopamine. It is of note that Clozaril (clozapine) a drug of particular (and pecuniary) interest to the MHRI targets serotonin rather than dopamine. The work of the “Molecular Schizophrenia Division” of the Institute is described, in the report (which is designed for the public), under the following subheadings:

1. Dopamine Neurobiology and Schizophrenia

2. Serotonin Neurobiology and Schizophrenia

3. Related Neurotransmitter Systems in Schizophrenia

4. Neuropeptides, Stress and Psychosis

5. Making Diagnoses from Case Histories for use in Post-mortem Studies

6. Potential Outcome from the Research in the Molecular Schizophrenia Division

7. Summary

The “potential outcome”, after many years of research and millions of dollars of public money is hardly ambitious (or ‘multifaceted’):

“The Molecular Schizophrenia Division has carried out extensive research to determine how important neurotransmitter pathways in the brain may be involved in the pathology of schizophrenia. This multi-faceted approach should lead to a better understanding of these mechanisms and how they may be involved in the genesis of schizophrenic symptoms. In understanding these mechanisms, we believe we will be able to move towards designing better drugs for the treatment of an illness. Indeed, early work by scientists who are now members of 449

this Division have led to the instigation of a drug development program which involves both the Mental Health Research Institute and the Victorian College of Pharmacy. The program is attempting to identify a specific site in the human brain which is believed to be important in the pathology of schizophrenia. Even with the limited technology at hand [a suggestion that they need more], we have been able to generate lead compounds that might act as drugs and influence the binding site of interest [the report localises this as the “CA4 region of the hippocampus”]. Thus when this binding site is finally purified and cloned, such candidate drugs will be able to target the binding site [potential development of chemical restraints and neurotoxins]. Arrangements are already in place to begin the next phase of studies. If this project is successful, it will involve an intensive synthesis of compounds that will be tested for the activity at the specific site. It is hoped that one or more of these will eventually prove to be useful in the treatment of schizophrenia.” (p.21)

The “Mission” statement on the second page of the MHRI Annual Report does not say anything about developing new drugs and experimenting with them on the Vicorian public. It reads:

“The Mental Health Research Institute’s mission is to further knowledge in mental health, behaviour and neuroscience. Researchers work to investigate the nature, origins and causes of psychiatric diseases and apply the knowledge they gain to improve diagnosis, treatment and, ultimately, prevent mental illnesses such as Alzheimer’s disease and schizophrenia.” (p.2)

In the second sentence we can see an immediate narrowing of focus and splintering resulting in a radical departure from the commendable objective of furthering knowledge in mental health, behaviour and neuroscience. The word mental, from the Latin mens, means ‘pertaining to the mind’. The word psyche is taken to be the Greek equivalent of mens, however it is also translated as meaning “soul”. Either way, the English (and ‘Western’) use of these words is best translated as “of or pertaining to the mind”. Thus psychic depression is the same thing as mental depression, psychic awareness is the same 450

thing as mental awareness, psychic ability is the same thing as mental ability and so on. By the same token mental health is the same thing as psychic health. The word “psychological” (a combination of the Greek psyche with logos, meaning ‘word’) is a term to define knowledge and study of the mind. “Psychological medicine” is a composite of two very different traditions: those of “psychology” and “medicine”. The word “medicine”, from the Latin medicina was given three rather confusing definitions in the 6th edition (1976) of the Concise Oxford Dictionary:

1. Art of restoring and preserving health, esp. by means of remedial substances and regulation of diet etc., as opp. to surgery and obstetrics

2. Substance, esp. one taken internally, used in this; (among primitive peoples) spell, charm, fetish, (~-man, magician)

3. A dose etc. one’s own ~, treatment such as one is accustomed to giving others; take one’s ~, submit to disagreeable thing; ~ ball, stuffed leather ball thrown and caught as a means of exercise; ~ chest, box containing remedies

Truly a mixture of good and bad, and clearly illustrative of the splintered history of the medical profession. The first and second definitions reveal the routine denigration of “native” and “primitive” healers (“medicine-men”) who were insinuated as having only skills of casting “spells and charms” over gullible and supersitious subjects rather than a genuine “art of restoring and preserving health”. What is somewhat surprising is that science does not rate a mention in this dictionary’s definition of medicine – yet the medical profession claims to be part of the scientific community rather than of the artistic community. To become a medical doctor students are obliged to memorise enormous amounts of science and hardly anything about “the arts” – including history, geography, philosophy and politics.

451

The splintering of medical education has been a particular concern of mine and many others for many years, but the problem continues to worsen. It is worsening not because the problems of splintering are unrecognised but because of political and economic considerations. The stategy of “divide and rule” can also be used to divide and confuse, divide and control, and divide and exploit. Division of loyalties and division of society into different factions which are then turned against each other has a long history in political science. At the same time division of knowledge is very profitable to educational institutions and governments (if they charge fees for degrees, diplomas and certificates) since the more knowledge is divided (splintered) the more “variety” of courses can be offered. Each university department is a political entity that is designed to compete with other departments for funds, space, reputation and “the best students”. The government and educational institutions are well aware of the economic value of keen, active, young minds but less aware of the needs of these minds for freedom and the owners of these minds to be the students themselves.

One of the main things that is sold in various educational courses around the world is discipline- specific jargon. Every discipline has its jargon and it is not possible to understand the arguments put forward within various disciplines without understanding the relevant jargon and associated assumptions and concepts. Jargon is also constantly being created within the sciences and within the arts, and constantly entering into colloquial usage (often to mean very different things to its “academic meaning”). This phenomenon adds to the public drive to seek enlightenment from the institutions from which the jargon is emanating – and which house the self-professed (and generally acknowledged) experts on the various disciplines. In the present work and much of my previous work I have attempted to translate medical, and particularly psychiatric and neurological jargon into plain English and am increasingly reminded of the fable of the Emperor’s New Clothes!

452

DISEASE CREATION BY PSYCHIATRY – SOME DIAGRAMS

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Psy 456

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